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General NPI Number Information
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NPI Number | 1477548816
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Entity Type | Organization
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Legal Business Name | PHUC T NGUYEN
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 2605 W ORANGETHORPE AVE
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City | FULLERTON
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State | CA
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Zip | 92833-4209
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Country | US
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Telephone | 714-449-0448
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Fax | 714-449-0987
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Provider Business Mailing Address
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Address Line | 2605 W ORANGETHORPE AVE
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City | FULLERTON
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State | CA
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Zip | 92833-4209
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Country | US
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Telephone | 714-449-0448
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Fax | 714-449-0987
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Authorized Official
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Title or Position | OWNER / PIC
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Name | MRS. PHUC THI NGUYEN
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Credential | RPH
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Telephone | 714-449-0448
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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 | PHY44273
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License Number State | CA
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