Provider Demographics
NPI:1457101800
Name:NGUYEN, TUAN NGOC (RPH)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 PLUMAS ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3490
Mailing Address - Country:US
Mailing Address - Phone:530-443-2055
Mailing Address - Fax:530-443-2054
Practice Address - Street 1:1215 PLUMAS ST STE 1201
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3490
Practice Address - Country:US
Practice Address - Phone:530-443-2055
Practice Address - Fax:530-443-2054
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist