Provider Demographics
NPI:1558655852
Name:NGUYEN, JOSEPHINE MINHHANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:MINHHANH
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 1:1728 LA MANCHA
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-4126
Mailing Address - Country:US
Mailing Address - Phone:626-230-0644
Mailing Address - Fax:
Practice Address - Street 1:23965 IRONWOOD AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7153
Practice Address - Country:US
Practice Address - Phone:951-242-1742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 64050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist