Organization
DAVID TRIEU NGUYEN
Active
Other names
EL PORTAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BA HUYNH (MANAGER)
(559) 940-4186
Entity
Organization
Contact information
Practice address
2407 JENSEN AVE STE 101, SANGER, CA 93657-2248
(559) 399-8644
(559) 399-8643
Mailing address
2407 JENSEN AVE, SUITE 101, SANGER, CA 93657-2248
(559) 399-8644
(559) 399-8643
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54339
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158574
PK
—
Enumeration date
03/03/2016
Last updated
04/18/2016
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