Individual provider Active NPI

Nick Nhut Nguyen, PHARMD

  • Pharmacist
  • Pomona, CA
National Provider Identifier
1104433812
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
83431 Issued in CA
Practice address
701 Rio Rancho Rd
Pomona, CA 91766-7018
Phone
(909) 634-3152
NPI assigned
Sep 26, 2020
Last updated
Sep 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 83431 CA Primary

Addresses

Primary practice location

701 Rio Rancho Rd
Pomona, CA 91766-7018

Mailing address

10691 Ballast Ave
Garden Grove, CA 92843-5308
Phone (714) 333-8271

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
83431CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601078400000",
    "number": "1104433812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10691 BALLAST AVE",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928435308",
            "telephone_number": "714-333-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 RIO RANCHO RD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667018",
            "telephone_number": "909-634-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NICK",
        "middle_name": "NHUT",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.