Active NPI
Nam Nguyen
- Pharmacist
- Orange, CA
National Provider Identifier
1053693556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 53641
- Practice address
- 111 S Main St
Orange, CA 92868-2842 - Phone
- (714) 289-3650
- NPI assigned
- Sep 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 53641 | CA | Primary |
Addresses
Primary practice location
111 S Main St
Orange, CA 92868-2842
Mailing address
9700 Marigold Ave
Fountain Valley, CA 92708-2017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53641 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Orange, CA
- NPI 1760497044
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1053693556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9700 MARIGOLD AVE",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927082017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S MAIN ST",
"city": "ORANGE",
"state": "CA",
"postal_code": "928682842",
"telephone_number": "714-289-3650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "NAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "53641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.