Provider Demographics
NPI:1487782140
Name:NGUYEN, CHRISTINE MINH (PHARM D)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 10TH AVE UNIT 704
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7269
Mailing Address - Country:US
Mailing Address - Phone:510-461-1343
Mailing Address - Fax:
Practice Address - Street 1:527 10TH AVE UNIT 704
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-7269
Practice Address - Country:US
Practice Address - Phone:510-461-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55201183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist