Healthcare Provider Details

I. General information

NPI: 1124398060
Provider Name (Legal Business Name): ANH TRUNG DAO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 07/21/2022
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14516 BROOKHURST ST
WESTMINSTER CA
92683-5750
US

IV. Provider business mailing address

14516 BROOKHURST ST
WESTMINSTER CA
92683-5750
US

V. Phone/Fax

Practice location:
  • Phone: 714-852-3789
  • Fax: 714-852-3639
Mailing address:
  • Phone: 714-852-3789
  • Fax: 714-852-3639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number66432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: