Active NPI
Liem Dai Nguyen, PHARMD
- Pharmacist
- San Rafael, CA
National Provider Identifier
1356622369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63082
- Practice address
- 155 Northgate One
San Rafael, CA 94903-3417 - Phone
- (415) 479-2260
- Fax
- (415) 479-2458
- NPI assigned
- Sep 3, 2011
- 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 | 63082 | CA | Primary |
Addresses
Primary practice location
155 Northgate One
San Rafael, CA 94903-3417
Mailing address
155 Northgate One
San Rafael, CA 94903-3417
Phone (415) 479-2260
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
| License | State | Type | Specialty |
|---|---|---|---|
| 63082 | CA | MD | Pharmacist |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315008000000",
"number": "1356622369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 NORTHGATE ONE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949033417",
"telephone_number": "415-479-2260",
"fax_number": "415-479-2458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 NORTHGATE ONE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949033417",
"telephone_number": "415-479-2260",
"fax_number": "415-479-2458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "LIEM",
"middle_name": "DAI",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-03",
"last_updated": "2011-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.