Provider Demographics
NPI:1962634717
Name:CHIN, NHUNGUYET PHAM LE (PHARM D)
Entity Type:Individual
Prefix:
First Name:NHUNGUYET
Middle Name:PHAM LE
Last Name:CHIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:NHUNGUYET
Other - Middle Name:THI
Other - Last Name:PHAMLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:901 NEVIN AVE
Mailing Address - Street 2:BUILDING A, SECOND FLOOR
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3143
Mailing Address - Country:US
Mailing Address - Phone:510-307-3173
Mailing Address - Fax:
Practice Address - Street 1:901 NEVIN AVE
Practice Address - Street 2:BUILDING A, SECOND FLOOR
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3143
Practice Address - Country:US
Practice Address - Phone:510-307-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist