Provider Demographics
NPI:1932409448
Name:NGUYEN, VIET THIEN (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:VIET
Middle Name:THIEN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:MR
Other - First Name:AUGUSTIN
Other - Middle Name:THIEN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:867 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-6751
Mailing Address - Country:US
Mailing Address - Phone:510-747-1647
Mailing Address - Fax:510-747-1646
Practice Address - Street 1:867 ISLAND DR
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94502-6751
Practice Address - Country:US
Practice Address - Phone:510-747-1647
Practice Address - Fax:510-747-1646
Is Sole Proprietor?:No
Enumeration Date:2010-10-31
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist