Healthcare Provider Details

I. General information

NPI: 1962124818
Provider Name (Legal Business Name): CHRISTOPHER PHILIP HUYNH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 05/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

783 RIO DEL MAR BLVD STE 3
APTOS CA
95003-4700
US

IV. Provider business mailing address

3142 PLEASANT LAKE LN
SAN JOSE CA
95148-1249
US

V. Phone/Fax

Practice location:
  • Phone: 831-687-0460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84873
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: