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General NPI Number Information
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NPI Number | 1376901801
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Entity Type | Individual
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Provider Name | SANDY MAI TRANG NGUYEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 113 WATERWORKS WAY #160A
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City | IRVINE
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State | CA
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Zip | 92618-3167
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Country | US
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Telephone | 949-788-9990
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Fax | 949-336-6460
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Provider Business Mailing Address
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Address Line | 15642 SAND CANYON AVE #50061
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City | IRVINE
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State | CA
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Zip | 92619-5478
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Country | US
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Telephone | 949-788-9990
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Fax | 949-336-6460
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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 | 58664
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License Number State | CA
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