Provider Demographics
NPI:1033528419
Name:NGUYEN, THANH THI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:THANH
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17150 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91745-1818
Mailing Address - Country:US
Mailing Address - Phone:626-854-1006
Mailing Address - Fax:626-854-1046
Practice Address - Street 1:17150 GALE AVE
Practice Address - Street 2:
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91745-1818
Practice Address - Country:US
Practice Address - Phone:626-854-1006
Practice Address - Fax:626-854-1046
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH41639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist