MEDICARE: KIMCHI NGUYEN

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	18437	NV

General Provider Information

NPI Number	:	1568399004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMCHI NGUYEN

Provider Business Mailing Address
First Line	:	5564 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0810
Country	:	US
Telephone Number	:	702-399-3186
Fax Number	:	702-399-3295

Provider Business Practice Location Address
First Line	:	5564 CAMINO AL NORTE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0810
Country	:	US
Telephone Number	:	702-399-3186
Fax Number	:	702-399-3295

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

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ KIMCHI NGUYEN ” Practice Location

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