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General NPI Number Information
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NPI Number | 1407771249
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Entity Type | Individual
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Provider Name | MICHELLE THIEN-KIM NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 08/11/2026
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Last Update Date | 08/11/2026
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Provider Practice Location Address
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Address Line | 3515 HARBOR BLVD
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City | COSTA MESA
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State | CA
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Zip | 92626-1437
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Country | US
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Telephone | 877-445-6874
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Fax |
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Provider Business Mailing Address
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Address Line | 15213 SEVERYNS RD
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City | TUSTIN
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State | CA
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Zip | 92782-1797
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Country | US
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Telephone | 949-880-9340
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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 | 32333
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63944
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License Number State | CA
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