Provider Demographics
NPI:1740276195
Name:NGUYEN, BAY VAN (RPH)
Entity type:Individual
Prefix:MR
First Name:BAY
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1661 BURDETTE DR
Mailing Address - Street 2:STE AB
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1665
Mailing Address - Country:US
Mailing Address - Phone:408-223-0180
Mailing Address - Fax:408-223-2366
Practice Address - Street 1:1661 BURDETTE DR
Practice Address - Street 2:STE AB
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1665
Practice Address - Country:US
Practice Address - Phone:408-223-0180
Practice Address - Fax:408-223-2366
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPHY43751183500000X
CARPH38728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0671640001Medicare NSC