Healthcare Provider Details

I. General information

NPI: 1629853098
Provider Name (Legal Business Name): EMILY NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 MERCED ST
SAN LEANDRO CA
94577-4228
US

IV. Provider business mailing address

62 MEADOWLAND DR
MILPITAS CA
95035-4415
US

V. Phone/Fax

Practice location:
  • Phone: 510-454-6770
  • Fax:
Mailing address:
  • Phone: 408-834-0807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03443404
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number89129
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: