David Trieu Nguyen

Organization Active NPI Community/Retail Pharmacy · Sanger, CA

NPI 1679933535 · NPPES record last updated Apr 18, 2016

Key facts

NPI
1679933535
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PHY54339 (CA)
Legal business name
DAVID TRIEU NGUYEN
Practice address
2407 Jensen Ave Ste 101
Sanger, CA 93657-2248
Phone
(559) 399-8644
Fax
(559) 399-8643
NPI assigned
Mar 3, 2016
Organization subpart
No

Authorized official

Name
Ba Huynh
Title
Manager
Phone
(559) 940-4186

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY54339 CA Yes
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

2407 Jensen Ave Ste 101
Sanger, CA 93657-2248

Mailing address

2407 Jensen Ave
Suite 101
Sanger, CA 93657-2248
Phone (559) 399-8644

Other identifiers

IdentifierTypeStateIssuer
2158574OtherPK

Other names

  • EL PORTAL PHARMACY Doing business as

Other providers in Sanger, CA

All providers in Sanger, CA · Community/Retail Pharmacy in California

Sources for this page

Verify at the official NPI Registry.