Dat Tan Nguyen, PHARMD
Individual provider Active NPI Pharmacist · Alturas, CA
NPI 1740705284 · NPPES record last updated Aug 5, 2017
Key facts
- NPI
- 1740705284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 75289 (CA)
- Practice address
- 228 W McDowell Ave
Alturas, CA 96101-3934 - Phone
- (530) 233-5131
- NPI assigned
- Aug 5, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75289 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 75289 | CA | Yes |
Addresses
Primary practice location
228 W McDowell Ave
Alturas, CA 96101-3934
Mailing address
228 W McDowell Ave
Alturas, CA 96101-3934
Phone (714) 887-3130
Other providers in Alturas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.