Provider Demographics
NPI:1023587870
Name:LE, NHU NGUYEN QUYNH (PHARMD)
Entity type:Individual
Prefix:
First Name:NHU NGUYEN QUYNH
Middle Name:
Last Name:LE
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 1:121 N BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-6135
Mailing Address - Country:US
Mailing Address - Phone:714-822-3180
Mailing Address - Fax:714-822-3181
Practice Address - Street 1:121 N BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6135
Practice Address - Country:US
Practice Address - Phone:714-822-3180
Practice Address - Fax:714-822-3181
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty