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Organization
TUAN NGUYEN
Active
Organization
TUAN NGUYEN
Active
Other names
MAI TRAM PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TUAN NGUYEN (OWNER PHARMACIST)
(415) 441-2672
Entity
Organization
Contact information
Practice address
512 ELLIS ST, SAN FRANCISCO, CA 94109-8103
(415) 441-2672
(415) 441-2763
Mailing address
512 ELLIS ST, SAN FRANCISCO, CA 94109-8103
(415) 441-2672
(415) 441-2763
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY40568
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0510885
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA405680
—
CA
Enumeration date
07/22/2006
Last updated
10/14/2011
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