Provider Demographics
NPI:1508167826
Name:NGUYEN, ANH-THU V (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANH-THU
Middle Name:V
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 1:12862 LEMONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-5521
Mailing Address - Country:US
Mailing Address - Phone:714-467-6108
Mailing Address - Fax:
Practice Address - Street 1:1380 BARSTOW RD
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-4944
Practice Address - Country:US
Practice Address - Phone:760-252-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64724183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist