Provider Demographics
NPI:1669067021
Name:NGUYEN, VIET XUAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VIET
Middle Name:XUAN
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 1:250 E HAZELWOOD DR APT 5
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2474
Mailing Address - Country:US
Mailing Address - Phone:323-532-3420
Mailing Address - Fax:
Practice Address - Street 1:250 E HAZELWOOD DR APT 5
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2474
Practice Address - Country:US
Practice Address - Phone:323-532-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-07
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty