=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003700378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DUNG THINGOC NGUYEN PHARM. D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2025
-----------------------------------------------------
Last Update Date | 06/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3901 LONE TREE WAY
-----------------------------------------------------
City | ANTIOCH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-779-7200
-----------------------------------------------------
Fax | 925-779-7227
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2213 TRINITY DRIVE
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-807-8690
-----------------------------------------------------
Fax | 925-779-7227
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 60108
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------