Provider Demographics
NPI:1134537996
Name:NGUYEN, VINH
Entity type:Individual
Prefix:
First Name:VINH
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 1:1375 N DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-1991
Mailing Address - Country:US
Mailing Address - Phone:831-998-9087
Mailing Address - Fax:
Practice Address - Street 1:1375 N DAVIS RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907-1991
Practice Address - Country:US
Practice Address - Phone:831-998-9087
Practice Address - Fax:831-998-9081
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist