Provider Demographics
NPI:1689972218
Name:NGUYEN, DIEM THUY (PHARMD)
Entity Type:Individual
Prefix:
First Name:DIEM
Middle Name:THUY
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 1:9652 SASKATCHEWAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3501
Mailing Address - Country:US
Mailing Address - Phone:619-788-3161
Mailing Address - Fax:
Practice Address - Street 1:9652 SASKATCHEWAN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3501
Practice Address - Country:US
Practice Address - Phone:619-788-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist