Provider Demographics
NPI:1669460804
Name:NGUYEN, JULIE LIENDINH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LIENDINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9008 GARVEY AVE
Mailing Address - Street 2:STE A
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3360
Mailing Address - Country:US
Mailing Address - Phone:626-280-7759
Mailing Address - Fax:626-280-8640
Practice Address - Street 1:9008 GARVEY AVE
Practice Address - Street 2:STE A
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3360
Practice Address - Country:US
Practice Address - Phone:626-280-7759
Practice Address - Fax:626-280-8640
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH40949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6073035OtherPIN
CAPHA460280Medicaid
CA6073035OtherPIN