Provider Demographics
NPI:1457924227
Name:NGUYEN, TUAN MINH DINH (PHARMD)
Entity Type:Individual
Prefix:
First Name:TUAN MINH
Middle Name:DINH
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 1:850 S GUILD AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-3170
Mailing Address - Country:US
Mailing Address - Phone:209-333-4900
Mailing Address - Fax:800-828-8787
Practice Address - Street 1:850 S GUILD AVE STE 100A
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-3170
Practice Address - Country:US
Practice Address - Phone:209-333-4900
Practice Address - Fax:800-828-8787
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist