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Individual

ANDY NGUYEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
975 E CYPRESS AVE, REDDING, CA 96002-1045
(530) 223-3995
Mailing address
1300 MARKET ST STE 209, REDDING, CA 96001-0633
(714) 552-1284

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
71506
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
91578503C
MEDI-CAL
CA
Enumeration date
04/12/2015
Last updated
04/12/2015
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