MEDICARE: JENNIFER 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	3336C0002X	Clinic Pharmacy	RPH85236	CA

General Provider Information

NPI Number	:	1699353540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	18916 WILLARD ST
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-1145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD BLDG 500
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

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

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	04/23/2026

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