Provider Demographics
NPI:1114213634
Name:NGUYEN, CHEE M (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHEE
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 COMMERCE AVE
Mailing Address - Street 2:T-2386
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-5213
Mailing Address - Country:US
Mailing Address - Phone:209-357-4821
Mailing Address - Fax:209-357-4831
Practice Address - Street 1:1000 COMMERCE AVE
Practice Address - Street 2:T-2386
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5213
Practice Address - Country:US
Practice Address - Phone:209-357-4821
Practice Address - Fax:209-357-4831
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist