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General NPI Number Information
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NPI Number | 1003018433
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Entity Type | Individual
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Provider Name | TAMMIE NGOC TU NGUYEN PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1205 E NORTH ST
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City | MANTECA
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State | CA
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Zip | 95336-4932
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Country | US
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Telephone | 209-239-8381
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Fax |
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Provider Business Mailing Address
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Address Line | 8882 HILDRETH LN
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City | STOCKTON
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State | CA
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Zip | 95212-9428
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Country | US
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Telephone | 209-473-9508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 53661
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License Number State | CA
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