Active NPI
Andrew Liem Nguyen, RPH
- Pharmacist
- Pomona, CA
National Provider Identifier
1700400447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82182
- Practice address
- 495 E Holt Ave
Pomona, CA 91767-5539 - Phone
- (909) 469-9534
- NPI assigned
- May 28, 2020
- 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 | 82182 | CA | Primary |
Addresses
Primary practice location
495 E Holt Ave
Pomona, CA 91767-5539
Mailing address
495 E Holt Ave
Pomona, CA 91767-5539
Phone (909) 256-9111
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
- Registered 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.
-
- Pharmacy
- Pomona, CA
- NPI 1992712954
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590624000000",
"number": "1700400447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 E HOLT AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917675539",
"telephone_number": "909-256-9111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 E HOLT AVE",
"city": "POMONA",
"state": "CA",
"postal_code": "917675539",
"telephone_number": "909-469-9534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "ANDREW",
"middle_name": "LIEM",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-28",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82182",
"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 May 28, 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.