Provider Demographics
NPI:1942206404
Name:NGUYEN, BUU-AN NGOC (PHARMD)
Entity Type:Individual
Prefix:
First Name:BUU-AN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-929 PUAMAEOLE ST
Mailing Address - Street 2:UNIT 5D
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2112
Mailing Address - Country:US
Mailing Address - Phone:808-433-0767
Mailing Address - Fax:808-433-0737
Practice Address - Street 1:459 PATTERSON ROAD
Practice Address - Street 2:PHARMACY SERVICE
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819
Practice Address - Country:US
Practice Address - Phone:808-433-0767
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist