MEDICARE: MS. TUAN QUOC VU RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH58053	CO

General Provider Information

NPI Number	:	1659657609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TUAN QUOC VU RPH

Provider Business Mailing Address
First Line	:	2018 BURROUGHS ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-6619
Country	:	US
Telephone Number	:	858-279-5080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2018 BURROUGHS ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-6619
Country	:	US
Telephone Number	:	858-279-5080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2011
Last Update Date	:	10/21/2011

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