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General NPI Number Information
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NPI Number | 1003454596
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Entity Type | Individual
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Provider Name | CHRISTOPHER NHIAWA VANG PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2019
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Last Update Date | 12/15/2019
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Provider Practice Location Address
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Address Line | 3093 MARLOW RD
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City | SANTA ROSA
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State | CA
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Zip | 95403-2426
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Country | US
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Telephone | 707-569-8504
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 N COVENTRY AVE
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City | FRESNO
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State | CA
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Zip | 93737-9439
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH81321
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License Number State | CA
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