Provider Demographics
NPI:1518241314
Name:NGUYEN, TAM MINH (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAM
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 1:1219 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-4313
Mailing Address - Country:US
Mailing Address - Phone:559-498-8283
Mailing Address - Fax:559-498-0252
Practice Address - Street 1:1219 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-4313
Practice Address - Country:US
Practice Address - Phone:559-498-8283
Practice Address - Fax:559-498-0252
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55442183500000X
TX41907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist