Healthcare Provider Details

I. General information

NPI: 1336670769
Provider Name (Legal Business Name): LINH VUONG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3924 ELM AVE
LONG BEACH CA
90807-2705
US

IV. Provider business mailing address

3924 ELM AVE
LONG BEACH CA
90807-2705
US

V. Phone/Fax

Practice location:
  • Phone: 562-212-0722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number52269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: