Provider Demographics
NPI:1578862553
Name:DUONG, NHAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NHAN
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
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 1:3250 W. GRANT LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377
Mailing Address - Country:US
Mailing Address - Phone:209-830-5342
Mailing Address - Fax:
Practice Address - Street 1:3250 W. GRANT LINE ROAD
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377
Practice Address - Country:US
Practice Address - Phone:209-830-5342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 52252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist