Provider Demographics
NPI:1942749106
Name:NGUYEN, ANH Y (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:Y
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 1:9568 CARROLL CANYON RD
Mailing Address - Street 2:APT 251
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4973
Mailing Address - Country:US
Mailing Address - Phone:678-936-9796
Mailing Address - Fax:
Practice Address - Street 1:9568 CARROLL CANYON RD
Practice Address - Street 2:APT 251
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4973
Practice Address - Country:US
Practice Address - Phone:678-936-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist