Provider Demographics
NPI:1225570682
Name:NGUYEN, HAN THI BICH (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:THI BICH
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 1:83053 AVENUE 48
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-9551
Mailing Address - Country:US
Mailing Address - Phone:760-262-8677
Mailing Address - Fax:
Practice Address - Street 1:83053 AVENUE 48
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-9551
Practice Address - Country:US
Practice Address - Phone:760-262-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 75456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist