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NPI Code Detail

MEDICARE: DR. KIEU LOAN NGUYEN PHD

MEDICARE:  DR. KIEU LOAN  NGUYEN  PHD
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
1183500000XPharmacist20408NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120408OTHERNVSTATE LICENSE

General Provider Information

NPI Number : 1992300479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIEU LOAN NGUYEN PHD
Provider Business Mailing Address
First Line : 3210 N TENAYA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-6239
Country : US
Telephone Number : 702-396-7840
Fax Number :
Provider Business Practice Location Address
First Line : 3210 N TENAYA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-6239
Country : US
Telephone Number : 702-396-7840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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Directions to “ DR. KIEU LOAN NGUYEN PHD” Practice Location

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