Provider Demographics
NPI:1811295983
Name:NGUYEN, LUCI THUYTRINH (RPH)
Entity type:Individual
Prefix:
First Name:LUCI
Middle Name:THUYTRINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7271 CAMINO ARROYO
Mailing Address - Street 2:COSTCO PHARMACY #760
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020
Mailing Address - Country:US
Mailing Address - Phone:408-848-0702
Mailing Address - Fax:408-848-0723
Practice Address - Street 1:7271 CAMINO ARROYO
Practice Address - Street 2:COSTCO PHARMACY #760
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020
Practice Address - Country:US
Practice Address - Phone:408-848-0702
Practice Address - Fax:408-848-0723
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA564761835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist