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NPI Code Detail

MEDICARE: ANGIE NGOC NGUYEN PHARM. D

MEDICARE: ANGIE NGOC NGUYEN PHARM. D
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
1183500000XPharmacist62161CA

General Provider Information

NPI Number : 1619252327
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE NGOC NGUYEN PHARM. D
Provider Business Mailing Address
First Line : 205 W SHAW AVE
Second Line :
City : CLOVIS
State : CA
Zip : 93612-3602
Country : US
Telephone Number : 559-325-1858
Fax Number : 559-325-3479
Provider Business Practice Location Address
First Line : 205 W SHAW AVE
Second Line :
City : CLOVIS
State : CA
Zip : 93612-3602
Country : US
Telephone Number : 559-325-1858
Fax Number : 559-325-3479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2011
Last Update Date : 10/13/2011

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