Provider Demographics
NPI:1053197913
Name:NGUYEN, BRIAN ANHTUAN (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANHTUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 GUESS ST
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1904
Mailing Address - Country:US
Mailing Address - Phone:626-320-4706
Mailing Address - Fax:
Practice Address - Street 1:6521 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1425
Practice Address - Country:US
Practice Address - Phone:818-933-2010
Practice Address - Fax:818-933-2018
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist