Healthcare Provider Details

I. General information

NPI: 1801433529
Provider Name (Legal Business Name): BETTY TUYET NHUNG KHUU RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2019
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 VALLEY BLVD
ROSEMEAD CA
91770-1900
US

IV. Provider business mailing address

9200 VALLEY BLVD
ROSEMEAD CA
91770-1900
US

V. Phone/Fax

Practice location:
  • Phone: 626-573-9477
  • Fax:
Mailing address:
  • Phone: 626-573-9477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: