Individual provider Active NPI

Khang Duy Nguyen, RPH

  • Pharmacist
  • Elk Grove, CA
National Provider Identifier
1750928776
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
81337 Issued in CA
Practice address
6116 Travo Way
Elk Grove, CA 95757-2801
Phone
(562) 290-2625
NPI assigned
Dec 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 81337 CA Primary

Addresses

Primary practice location

6116 Travo Way
Elk Grove, CA 95757-2801

Mailing address

6116 Travo Way
Elk Grove, CA 95757-2801
Phone (562) 290-2625

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL CVS Other

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

State licenses

LicenseStateTypeSpecialty
81337CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1750928776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6116 TRAVO WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957572801",
            "telephone_number": "562-290-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 TRAVO WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957572801",
            "telephone_number": "562-290-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHANG",
        "middle_name": "DUY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "81337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "endpointDescription": "CVS",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CVS",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "6116 Travo Way",
            "city": "Elk Grove",
            "state": "CA",
            "country_code": "US",
            "postal_code": "957572801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.