Provider Demographics
NPI:1821319302
Name:NGUYEN, NHAT TRUONG
Entity Type:Individual
Prefix:
First Name:NHAT
Middle Name:TRUONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8447 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-4405
Mailing Address - Country:US
Mailing Address - Phone:562-634-9074
Mailing Address - Fax:562-531-0202
Practice Address - Street 1:8447 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4405
Practice Address - Country:US
Practice Address - Phone:562-634-9074
Practice Address - Fax:562-531-0202
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist