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NPI Code Detail

MEDICARE: MR. ANDRE NGUYEN RPH

MEDICARE:  MR. ANDRE  NGUYEN  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist49734CA

General Provider Information

NPI Number : 1265885586
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDRE NGUYEN RPH
Provider Business Mailing Address
First Line : 6299 BRISTOL PKWY
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6903
Country : US
Telephone Number : 310-641-4426
Fax Number : 310-641-6391
Provider Business Practice Location Address
First Line : 6299 BRISTOL PKWY
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6903
Country : US
Telephone Number : 310-641-4426
Fax Number : 310-641-6391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2016
Last Update Date : 07/21/2016

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Directions to “ MR. ANDRE NGUYEN RPH” Practice Location

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