Provider Demographics
NPI:1821553876
Name:NGUYEN, UYEN KIM DANG (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:UYEN
Middle Name:KIM DANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-5106
Mailing Address - Country:US
Mailing Address - Phone:916-485-6917
Mailing Address - Fax:916-485-6967
Practice Address - Street 1:2636 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5106
Practice Address - Country:US
Practice Address - Phone:916-485-6917
Practice Address - Fax:916-485-6967
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist