Provider Demographics
NPI:1023279015
Name:NGUYEN VO INC
Entity type:Organization
Organization Name:NGUYEN VO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THUYDIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-590-9401
Mailing Address - Street 1:14150 BROOKHURST ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4657
Mailing Address - Country:US
Mailing Address - Phone:714-590-9401
Mailing Address - Fax:714-590-9484
Practice Address - Street 1:14150 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4657
Practice Address - Country:US
Practice Address - Phone:714-590-9401
Practice Address - Fax:714-590-9291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1991584OtherPK
CA1023279015Medicaid
CA1023279015Medicaid