Provider Demographics
NPI:1083862635
Name:DANG NGUYEN, PHILLIP PHUC HUY (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:PHUC HUY
Last Name:DANG NGUYEN
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 BOLSA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5964
Mailing Address - Country:US
Mailing Address - Phone:714-891-5280
Mailing Address - Fax:714-891-6970
Practice Address - Street 1:9433 BOLSA AVE STE B
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5964
Practice Address - Country:US
Practice Address - Phone:714-891-5280
Practice Address - Fax:714-891-6970
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist