Healthcare Provider Details

I. General information

NPI: 1477969004
Provider Name (Legal Business Name): KATIE DUONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE CHIU

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1534 E FLORENCE AVE
LOS ANGELES CA
90001-2536
US

IV. Provider business mailing address

1534 E FLORENCE AVE
LOS ANGELES CA
90001-2536
US

V. Phone/Fax

Practice location:
  • Phone: 323-587-6336
  • Fax:
Mailing address:
  • Phone: 323-587-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: