Provider Demographics
NPI:1295455566
Name:NGUYEN, PHUONG-DUYEN THI (RPH)
Entity type:Individual
Prefix:MRS
First Name:PHUONG-DUYEN
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 EL CAJON BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-3624
Mailing Address - Country:US
Mailing Address - Phone:619-458-9660
Mailing Address - Fax:619-326-8829
Practice Address - Street 1:5507 EL CAJON BLVD STE E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-3624
Practice Address - Country:US
Practice Address - Phone:619-458-9660
Practice Address - Fax:619-326-8829
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH72119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist