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NPI Code Detail

MEDICARE: KHOINGUYEN T NGUYEN PHARM.D

MEDICARE: KHOINGUYEN T 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
1183500000XPharmacist57940CA

General Provider Information

NPI Number : 1619322559
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHOINGUYEN T NGUYEN PHARM.D
Provider Business Mailing Address
First Line : 8280 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3413
Country : US
Telephone Number : 951-687-1308
Fax Number : 951-687-1543
Provider Business Practice Location Address
First Line : 8280 MAGNOLIA AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92504-3413
Country : US
Telephone Number : 951-687-1308
Fax Number : 951-687-1543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2016
Last Update Date : 04/28/2016

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