Healthcare Provider Details

I. General information

NPI: 1194634071
Provider Name (Legal Business Name): SANG VENG CHAU PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 N MOORE ST STE 1705
ARLINGTON VA
22209-1811
US

IV. Provider business mailing address

611 LAGUNA RD
FULLERTON CA
92835-2433
US

V. Phone/Fax

Practice location:
  • Phone: 562-508-1780
  • Fax:
Mailing address:
  • Phone: 562-508-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number61476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: