Healthcare Provider Details

I. General information

NPI: 1770255622
Provider Name (Legal Business Name): ANNIE VOONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 07/29/2022
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TORRANCE BLVD
TORRANCE CA
90503-4607
US

IV. Provider business mailing address

4101 TORRANCE BLVD
TORRANCE CA
90503-4607
US

V. Phone/Fax

Practice location:
  • Phone: 310-303-5358
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number85046
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: