Active NPI
Phuong Dieu Nguyen, PHARM. D.
- Pharmacist
- Modesto, CA
National Provider Identifier
1861779316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 48747
- Practice address
- 3500 Coffee Rd
Modesto, CA 95355-1305 - Phone
- (209) 341-0814
- Fax
- (209) 341-0849
- NPI assigned
- Nov 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 48747 | CA | Primary |
| Pharmacist | 183500000X | 13425 | NV |
Addresses
Primary practice location
3500 Coffee Rd
Modesto, CA 95355-1305
Mailing address
3604 Kee LN
Modesto, CA 95355-8662
Phone (209) 380-0338
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13425 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320969600000",
"number": "1861779316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3604 KEE LN",
"city": "MODESTO",
"state": "CA",
"postal_code": "953558662",
"telephone_number": "209-380-0338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953551305",
"telephone_number": "209-341-0814",
"fax_number": "209-341-0849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "PHUONG",
"middle_name": "DIEU",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-11",
"last_updated": "2011-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "48747",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "13425",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.