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General NPI Number Information
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NPI Number | 1528621968
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Entity Type | Individual
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Provider Name | TRIET M NGUYEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2019
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 1587 W EL CAMINO AVE
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City | SACRAMENTO
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State | CA
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Zip | 95833-1992
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Country | US
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Telephone | 916-568-1667
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Fax |
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Provider Business Mailing Address
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Address Line | 6112 ORCHARD HILL WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-8313
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Country | US
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Telephone | 916-533-6360
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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 | RPH-0016542
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License Number State | OR
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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 | 78317
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License Number State | CA
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