MEDICARE: MR. BAY VAN NGUYEN RPH

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	PHY43751	CA
2	183500000X	Pharmacist	RPH38728	CA

General Provider Information

NPI Number	:	1740276195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BAY VAN NGUYEN RPH

Provider Business Mailing Address
First Line	:	1661 BURDETTE DR
Second Line	:	STE AB
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1665
Country	:	US
Telephone Number	:	408-223-0180
Fax Number	:	408-223-2366

Provider Business Practice Location Address
First Line	:	1661 BURDETTE DR
Second Line	:	STE AB
City	:	SAN JOSE
State	:	CA
Zip	:	95121-1665
Country	:	US
Telephone Number	:	408-223-0180
Fax Number	:	408-223-2366

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/18/2017

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Directions to “ MR. BAY VAN NGUYEN RPH” Practice Location

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