Active NPI
Kelvin Nguyen
- Pharmacist
- Mesa, AZ
National Provider Identifier
1063285740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S026747
- Practice address
- 4316 S Signal Butte Rd
Mesa, AZ 85212-4214 - Phone
- (480) 296-7955
- Fax
- (480) 296-7954
- NPI assigned
- Nov 3, 2023
- Sex
- Male
- Sole proprietor
- No
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 | S026747 | AZ | Primary |
Addresses
Primary practice location
4316 S Signal Butte Rd
Mesa, AZ 85212-4214
Mailing address
11348 E Solina Cir
Mesa, AZ 85212-7038
Phone (480) 522-0827
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 |
|---|---|---|---|
| S026747 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1063285740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11348 E SOLINA CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852127038",
"telephone_number": "480-522-0827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4316 S SIGNAL BUTTE RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852124214",
"telephone_number": "480-296-7955",
"fax_number": "480-296-7954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KELVIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-03",
"last_updated": "2023-11-03",
"certification_date": "2023-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S026747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.