Provider Demographics
NPI:1669766390
Name:NGUYEN, BAO-LINH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BAO-LINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 FIRESTONE LN
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5242
Mailing Address - Country:US
Mailing Address - Phone:619-442-4701
Mailing Address - Fax:
Practice Address - Street 1:400 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-6446
Practice Address - Country:US
Practice Address - Phone:619-442-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-28
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist