Healthcare Provider Details

I. General information

NPI: 1356656698
Provider Name (Legal Business Name): VIET HIEN DUONG PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4322 S FIGUEROA ST
LOS ANGELES CA
90037-2642
US

IV. Provider business mailing address

12522 BLUE SPRUCE AVE
GARDEN GROVE CA
92840-5826
US

V. Phone/Fax

Practice location:
  • Phone: 323-235-3535
  • Fax:
Mailing address:
  • Phone: 323-235-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62277
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: