Healthcare Provider Details

I. General information

NPI: 1538441720
Provider Name (Legal Business Name): JOHN TRUNGTHU DAO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W TEHACHAPI BLVD
TEHACHAPI CA
93561-2559
US

IV. Provider business mailing address

18567 CALLENS CIR
FOUNTAIN VALLEY CA
92708-6622
US

V. Phone/Fax

Practice location:
  • Phone: 661-823-0163
  • Fax: 661-823-0742
Mailing address:
  • Phone: 714-963-5306
  • Fax: 661-823-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH64673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: