Healthcare Provider Details

I. General information

NPI: 1386154276
Provider Name (Legal Business Name): SARA KHUU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2017
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19267 COLIMA RD STE D
ROWLAND HEIGHTS CA
91748-3007
US

IV. Provider business mailing address

4422 EARLE AVE
ROSEMEAD CA
91770-1154
US

V. Phone/Fax

Practice location:
  • Phone: 626-474-2016
  • Fax: 626-474-2017
Mailing address:
  • Phone: 626-228-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: