Provider Demographics
NPI:1265857452
Name:NGUYEN, ANH HOANG (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1622
Mailing Address - Country:US
Mailing Address - Phone:213-480-3112
Mailing Address - Fax:213-480-0144
Practice Address - Street 1:3410 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1622
Practice Address - Country:US
Practice Address - Phone:213-480-3112
Practice Address - Fax:213-480-0144
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64605183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist