Healthcare Provider Details

I. General information

NPI: 1508080268
Provider Name (Legal Business Name): MINH UYEN CHAU VUONG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 WARNER AVE SUITE 318
FOUNTAIN VALLEY CA
92708-7506
US

IV. Provider business mailing address

11100 WARNER AVE SUITE 318
FOUNTAIN VALLEY CA
92708-7506
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-7200
  • Fax:
Mailing address:
  • Phone: 714-966-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number59079
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: