Individual provider Active NPI

Nam Phuoc Thanh Nguyen, PHARM. D.

  • Oncology Pharmacist
  • Vallejo, CA
National Provider Identifier
1659469518
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology PharmacistTaxonomy code 1835X0200X
License
48525 Issued in CA
Practice address
975 Sereno Dr
Oncology Department - Medicine 6
Vallejo, CA 94589-2441
Phone
(707) 651-2794
Fax
(707) 651-4243
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Pharmacist 1835X0200X 48525 CA Primary

Addresses

Primary practice location

975 Sereno Dr
Oncology Department - Medicine 6
Vallejo, CA 94589-2441

Mailing address

4894 Buckboard Way
El Sobrante, CA 94803-3819
Phone (510) 222-9164

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
48525CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659469518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4894 BUCKBOARD WAY",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948033819",
            "telephone_number": "510-222-9164",
            "fax_number": "707-651-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SERENO DR",
            "address_2": "ONCOLOGY DEPARTMENT - MEDICINE 6",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892441",
            "telephone_number": "707-651-2794",
            "fax_number": "707-651-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NAM",
        "middle_name": "PHUOC THANH",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "CA",
            "license": "48525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.