Provider Demographics
NPI:1316220361
Name:NGUYEN, THY MINH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THY
Middle Name:MINH
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:PO BOX 11882
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92255-1882
Mailing Address - Country:US
Mailing Address - Phone:714-487-3513
Mailing Address - Fax:
Practice Address - Street 1:72027 DINAH SHORE DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1781
Practice Address - Country:US
Practice Address - Phone:760-321-4892
Practice Address - Fax:760-770-3924
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist