1235752304 NPI number — HANG-THU THI NGUYEN PHARMD

Table of content: HANG-THU THI NGUYEN PHARMD (NPI 1235752304)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235752304 NPI number — HANG-THU THI NGUYEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
HANG-THU
Provider Middle Name:
THI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NGUYEN
Provider Other First Name:
HANG
Provider Other Middle Name:
THI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1235752304
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 KING DR APT 509
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94015-2966
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-499-7942
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4131 GEARY BLVD STE B10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94118-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-499-7942
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/24/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  80776 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)