Individual
DR. THEODORE PHAM NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, BCPS
Contact information
Practice address
529 MAPLE AVE, LOS ANGELES, CA 90013-1511
(213) 629-6200
Mailing address
510 S VERMONT AVE # 21-097, LOS ANGELES, CA 90020-1992
(714) 767-1878
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
23666
IA
183500000X
Pharmacist
786789
CA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
786789
CA
1835P1200X
Pharmacotherapy Pharmacist
786789
CA
Other
Enumeration date
10/03/2019
Last updated
12/14/2021
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