Provider Demographics
NPI:1073957700
Name:NGUYEN, KIEU T (PHARMD1)
Entity Type:Individual
Prefix:
First Name:KIEU
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 ENCINAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4649
Mailing Address - Country:US
Mailing Address - Phone:510-590-1141
Mailing Address - Fax:
Practice Address - Street 1:2626 ENCINAL AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4649
Practice Address - Country:US
Practice Address - Phone:510-590-1141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program