Provider Demographics
NPI:1861979981
Name:NGUYEN, NELSON V
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:V
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 1:662 E BORONDA RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3130
Mailing Address - Country:US
Mailing Address - Phone:831-443-0891
Mailing Address - Fax:831-443-1850
Practice Address - Street 1:662 E BORONDA RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3130
Practice Address - Country:US
Practice Address - Phone:831-443-0891
Practice Address - Fax:831-443-1850
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-21
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist