Healthcare Provider Details

I. General information

NPI: 1598301954
Provider Name (Legal Business Name): EMILY VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30116 EIGENBRODT WAY
UNION CITY CA
94587-1225
US

IV. Provider business mailing address

1484 SAN TOMAS AQUINO RD
SAN JOSE CA
95130-1134
US

V. Phone/Fax

Practice location:
  • Phone: 510-675-5741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP8611
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number81673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: