Healthcare Provider Details

I. General information

NPI: 1427534171
Provider Name (Legal Business Name): DR. CAROL QUACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 SPARKS BLVD
SPARKS NV
89436-8226
US

IV. Provider business mailing address

12010 HEMLOCK ST
EL MONTE CA
91732-1514
US

V. Phone/Fax

Practice location:
  • Phone: 775-626-7445
  • Fax:
Mailing address:
  • Phone: 626-804-4876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25068
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number253819
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9481524
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: