Organization
GISELE NGUYEN INC
Active
Other names
POMONA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GISELE NGUYEN PHARM D (OWNER)
(904) 620-6580
Entity
Organization
Contact information
Practice address
1182 E HOLT AVE, STE A, POMONA, CA 91767-5833
(909) 620-6580
(909) 620-6651
Mailing address
1182 E HOLT AVE, STE A, POMONA, CA 91767-5833
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY48761
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0595477
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA397660
—
CA
Enumeration date
11/06/2005
Last updated
10/15/2008
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