Provider Demographics
NPI:1265751895
Name:NGUYEN, HOA THAI (PHARMACIST)
Entity type:Individual
Prefix:
First Name:HOA
Middle Name:THAI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32856 NORTHSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-7211
Mailing Address - Country:US
Mailing Address - Phone:951-302-5687
Mailing Address - Fax:950-302-5687
Practice Address - Street 1:40481 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6401
Practice Address - Country:US
Practice Address - Phone:951-698-9793
Practice Address - Fax:951-698-3362
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH61825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist