Provider Demographics
NPI:1760825129
Name:NGUYEN, PATTY PHUONG (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:PHUONG
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:PO BOX 6525
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93912-6525
Mailing Address - Country:US
Mailing Address - Phone:408-952-9252
Mailing Address - Fax:
Practice Address - Street 1:875 WINIFRED DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-3345
Practice Address - Country:US
Practice Address - Phone:408-952-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist