Provider Demographics
NPI:1790081768
Name:NGUYEN, THAO UYEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:UYEN
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 1:1709 AUTOMATION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-1866
Mailing Address - Country:US
Mailing Address - Phone:408-678-2159
Mailing Address - Fax:408-678-2156
Practice Address - Street 1:1709 AUTOMATION PKWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1866
Practice Address - Country:US
Practice Address - Phone:408-678-2159
Practice Address - Fax:408-678-2156
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist