Healthcare Provider Details

I. General information

NPI: 1427327386
Provider Name (Legal Business Name): ANDREW HOAI NGUYEN PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 03/05/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12505 BEACH BLVD STE A2
STANTON CA
90680-4020
US

IV. Provider business mailing address

12505 BEACH BLVD STE A2
STANTON CA
90680-4020
US

V. Phone/Fax

Practice location:
  • Phone: 714-584-9599
  • Fax: 714-248-9115
Mailing address:
  • Phone: 714-584-9599
  • Fax: 714-248-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: