Healthcare Provider Details

I. General information

NPI: 1467945394
Provider Name (Legal Business Name): THUY TRANG NGOC NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 W 190TH ST
TORRANCE CA
90503-1004
US

IV. Provider business mailing address

21143 HAWTHORNE BLVD # 358
TORRANCE CA
90503-4615
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-5607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: