Healthcare Provider Details

I. General information

NPI: 1285254300
Provider Name (Legal Business Name): TU NGUYEN DOAN VUONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 04/18/2020
Certification Date: 04/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DUARTE RD
DUARTE CA
91010-3012
US

IV. Provider business mailing address

9315 BOLSA AVE UNIT 53
WESTMINSTER CA
92683-5902
US

V. Phone/Fax

Practice location:
  • Phone: 626-256-4673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number78963
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: