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General NPI Number Information
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NPI Number | 1003223256
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Entity Type | Individual
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Provider Name | JOHNNY QUOC NGUYEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 07/21/2014
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Provider Practice Location Address
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Address Line | 7015 N WEST AVE
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City | FRESNO
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State | CA
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Zip | 93711-0461
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Country | US
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Telephone | 559-440-1404
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Fax | 559-440-1407
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Provider Business Mailing Address
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Address Line | 5048 N RENDEZVOUS WAY
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City | CLOVIS
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State | CA
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Zip | 93619
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Country | US
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Telephone | 714-352-9926
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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 | 70015
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License Number State | CA
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