Provider Demographics
NPI:1134562440
Name:NGUYEN, TRUONG X (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TRUONG
Middle Name:X
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 1:3205 DONOVAN RANCH RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3722
Mailing Address - Country:US
Mailing Address - Phone:714-866-0873
Mailing Address - Fax:
Practice Address - Street 1:3205 DONOVAN RANCH RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3722
Practice Address - Country:US
Practice Address - Phone:714-866-0873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 48943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist