Provider Demographics
NPI:1033658315
Name:NGUYEN, ANH-THU J
Entity type:Individual
Prefix:
First Name:ANH-THU
Middle Name:J
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92684-0335
Mailing Address - Country:US
Mailing Address - Phone:714-251-7313
Mailing Address - Fax:
Practice Address - Street 1:12470 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1017
Practice Address - Country:US
Practice Address - Phone:562-907-3509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-19
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist