Provider Demographics
NPI:1467500538
Name:NGUYEN, KAITLIN PHUNG HUYNH (PHARM D)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:PHUNG HUYNH
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 1:10202 PORT ROYALE CV
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3524
Mailing Address - Country:US
Mailing Address - Phone:714-277-0864
Mailing Address - Fax:
Practice Address - Street 1:10202 PORT ROYALE CV
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-3524
Practice Address - Country:US
Practice Address - Phone:714-277-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist