Healthcare Provider Details
I. General information
NPI: 1669698742
Provider Name (Legal Business Name): AUDREY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9741 BOLSA AVE STE# 116
WESTMINSTER CA
92683-6601
US
IV. Provider business mailing address
12641 WYNANT DR
GARDEN GROVE CA
92841-4440
US
V. Phone/Fax
- Phone: 714-531-1983
- Fax: 714-531-1989
- Phone: 714-531-1983
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 48557 |
| License Number State | CA |
VIII. Authorized Official
Name: MS.
AUDREY
NGOCDAO
VU
Title or Position: PRESIDENT
Credential: PHARM. D
Phone: 714-531-1983