Provider Demographics
NPI:1871968214
Name:NGUYEN, PAUL (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 DELGANY ST
Mailing Address - Street 2:UNIT 1266
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1684
Mailing Address - Country:US
Mailing Address - Phone:503-998-4339
Mailing Address - Fax:
Practice Address - Street 1:16910 E QUINCY AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2745
Practice Address - Country:US
Practice Address - Phone:303-699-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist