MEDICARE: LAN A, NGUYEN-SUEKAWA

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	46263	CA

General Provider Information

NPI Number	:	1972976561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAN A, NGUYEN-SUEKAWA

Provider Business Mailing Address
First Line	:	3081 STEVENS CREEK BLVD
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6704
Country	:	US
Telephone Number	:	408-241-5141
Fax Number	:	408-243-8312

Provider Business Practice Location Address
First Line	:	3081 STEVENS CREEK BLVD
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6704
Country	:	US
Telephone Number	:	408-241-5141
Fax Number	:	408-243-8312

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

Provider Enumeration Date	:	11/05/2015
Last Update Date	:	11/05/2015

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Directions to “ LAN A, NGUYEN-SUEKAWA ” Practice Location

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