Provider Demographics
NPI:1952309627
Name:NGUYEN, THUY
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 SENTER RD
Mailing Address - Street 2:STE 26
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-2608
Mailing Address - Country:US
Mailing Address - Phone:408-298-1385
Mailing Address - Fax:408-298-0574
Practice Address - Street 1:2114 SENTER RD
Practice Address - Street 2:STE 26
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2608
Practice Address - Country:US
Practice Address - Phone:408-298-1385
Practice Address - Fax:408-298-0574
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHA406930183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist