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General NPI Number Information
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NPI Number | 1811216450
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Entity Type | Individual
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Provider Name | AN THU NGUYEN RPH
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Gender | Female
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 12897 HARBOR BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92840-5808
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Country | US
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Telephone | 714-636-1143
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Fax | 714-636-1856
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Provider Business Mailing Address
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Address Line | 4790 IRVINE BLVD #105-211
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City | IRVINE
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State | CA
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Zip | 92620-1973
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Country | US
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Telephone | 714-368-0602
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Fax | 714-368-0602
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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 | RPH50747
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License Number State | CA
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