Healthcare Provider Details

I. General information

NPI: 1558245423
Provider Name (Legal Business Name): ANDREW HO VUONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1362 3RD AVE
SAN FRANCISCO CA
94122-2719
US

IV. Provider business mailing address

1362 3RD AVE
SAN FRANCISCO CA
94122-2719
US

V. Phone/Fax

Practice location:
  • Phone: 408-568-5394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: