Provider Demographics
NPI:1437286507
Name:SAIGON PHARMACY
Entity Type:Organization
Organization Name:SAIGON PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:HUU
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-531-1740
Mailing Address - Street 1:14384 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4608
Mailing Address - Country:US
Mailing Address - Phone:714-531-1740
Mailing Address - Fax:714-531-9624
Practice Address - Street 1:14384 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4608
Practice Address - Country:US
Practice Address - Phone:714-531-1740
Practice Address - Fax:714-531-9624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY433423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA433420Medicaid
CA4010180001Medicare ID - Type Unspecified