1265742894 NPI number — JANE GIANG NGUYEN PHARM.D.

Table of content: JANE GIANG NGUYEN PHARM.D. (NPI 1265742894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265742894 NPI number — JANE GIANG NGUYEN PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
JANE
Provider Middle Name:
GIANG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HWANG
Provider Other First Name:
JANE
Provider Other Middle Name:
GIANG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARM.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1265742894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4722 AMALFI ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CYPRESS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90630-3589
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-220-8070
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12567 CARSON ST
Provider Second Line Business Practice Location Address:
UNIT NUMBER 155-0601
Provider Business Practice Location Address City Name:
HAWAIIAN GARDENS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90716-1607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-220-8070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2010

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: 183500000X , with the licence number:  60794 , 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)