MEDICARE: ANH TUYET NGUYEN PHARMD

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
1	183500000X	Pharmacist	53124	CA

General Provider Information

NPI Number	:	1316251093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANH TUYET NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	21042 BARCLAY LN
Second Line	:
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-5871
Country	:	US
Telephone Number	:	949-235-4057
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 E 17TH ST
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-3831
Country	:	US
Telephone Number	:	949-646-4960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	08/04/2010

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