Provider Demographics
NPI:1801483763
Name:NGUYEN, GINA GIAU NGOC (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:GINA GIAU
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8551 BOYD AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2504
Mailing Address - Country:US
Mailing Address - Phone:714-548-9582
Mailing Address - Fax:
Practice Address - Street 1:40657 ROAD 128
Practice Address - Street 2:
Practice Address - City:CUTLER
Practice Address - State:CA
Practice Address - Zip Code:93615-2003
Practice Address - Country:US
Practice Address - Phone:510-469-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist