Healthcare Provider Details

I. General information

NPI: 1982989786
Provider Name (Legal Business Name): VI THUY VU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 RILEY ST
FOLSOM CA
95630-3511
US

IV. Provider business mailing address

1100 RILEY ST
FOLSOM CA
95630-3511
US

V. Phone/Fax

Practice location:
  • Phone: 916-983-5862
  • Fax: 916-983-5894
Mailing address:
  • Phone: 916-983-5862
  • Fax: 916-983-5894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH60441
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: