Provider Demographics
NPI:1568233070
Name:NGUYEN, HANNAH TRAM-ANH
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:TRAM-ANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24462 SILVER SPUR LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4089
Mailing Address - Country:US
Mailing Address - Phone:949-973-8617
Mailing Address - Fax:
Practice Address - Street 1:5385 ALTON PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-8609
Practice Address - Country:US
Practice Address - Phone:949-733-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA88548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist