Provider Demographics
NPI:1164883153
Name:NGUYEN, VICTORIA Q (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:Q
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 1:777 S HARBOR BLVD STE E-163
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-6877
Mailing Address - Country:US
Mailing Address - Phone:714-328-0527
Mailing Address - Fax:401-216-4274
Practice Address - Street 1:175 E 17TH ST
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3708
Practice Address - Country:US
Practice Address - Phone:949-631-9223
Practice Address - Fax:949-631-6907
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66586183500000X
VA0202210220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist