Provider Demographics
NPI:1184212961
Name:NGUYEN, BRANDON NHU (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:NHU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21425 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1214
Mailing Address - Country:US
Mailing Address - Phone:714-725-5020
Mailing Address - Fax:
Practice Address - Street 1:200 WESTMINSTER MALL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4984
Practice Address - Country:US
Practice Address - Phone:714-657-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist