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General NPI Number Information
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NPI Number | 1700258209
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Entity Type | Individual
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Provider Name | TIMOTHY NGUYEN PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 500 UNIVERSITY AVE STE 110
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City | SACRAMENTO
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State | CA
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Zip | 95825-6504
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Country | US
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Telephone | 916-900-2114
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Fax | 916-900-2116
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Provider Business Mailing Address
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Address Line | 9619 HAHN WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-4613
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Country | US
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Telephone | 916-478-4038
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Fax | 916-900-2116
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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 | 56422
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License Number State | CA
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