Healthcare Provider Details

I. General information

NPI: 1124186119
Provider Name (Legal Business Name): VANNARAT ARYN HSU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ARYN HSU

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4647 ZION AVE INPATIENT PHARMACY
SAN DIEGO CA
92120-2507
US

IV. Provider business mailing address

4647 ZION AVE INPATIENT PHARMACY
SAN DIEGO CA
92120
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-4655
  • Fax:
Mailing address:
  • Phone: 925-295-4655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: