Healthcare Provider Details

I. General information

NPI: 1639230857
Provider Name (Legal Business Name): MAIKHANH DINH NGUYEN PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 STONERIDGE DR
PLEASANTON CA
94588-4501
US

IV. Provider business mailing address

6098 KINGSMILL TER
DUBLIN CA
94568-7778
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5434
  • Fax: 925-847-5252
Mailing address:
  • Phone: 925-847-5434
  • Fax: 925-847-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53947
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: