Provider Demographics
NPI:1295161248
Name:NGUYEN, CHRISTIAN QUANG (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:QUANG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 GARDNER FIELD RD
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-9726
Mailing Address - Country:US
Mailing Address - Phone:661-763-5951
Mailing Address - Fax:
Practice Address - Street 1:301 GARDNER FIELD RD
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-9726
Practice Address - Country:US
Practice Address - Phone:661-763-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63874183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist