Healthcare Provider Details

I. General information

NPI: 1033778402
Provider Name (Legal Business Name): TIEUMY GIAO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR PHARMACY BLDG 3, DECK 3
SAN DIEGO CA
92134-8538
US

IV. Provider business mailing address

34800 BOB WILSON DR PHARMACY BLDG 3, DECK 3
SAN DIEGO CA
92134-6200
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-9897
  • Fax: 619-532-5531
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80290
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number80290
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number80290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: