Provider Demographics
NPI:1619031903
Name:NGUYEN, HUYEN THU (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HUYEN
Middle Name:THU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23424
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95153-3424
Mailing Address - Country:US
Mailing Address - Phone:408-849-2424
Mailing Address - Fax:
Practice Address - Street 1:796 APPLE TERRACE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95111
Practice Address - Country:US
Practice Address - Phone:408-849-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist