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General NPI Number Information
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NPI Number | 1013212323
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Entity Type | Organization
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Legal Business Name | CUONG TRINH PHARM D INC
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 14777 LOS GATOS BLVD STE 101
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City | LOS GATOS
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State | CA
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Zip | 95032-2059
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Country | US
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Telephone | 408-356-4848
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Fax | 408-356-4949
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Provider Business Mailing Address
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Address Line | 14777 LOS GATOS BLVD STE 101
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City | LOS GATOS
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State | CA
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Zip | 95032-2059
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Country | US
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Telephone | 408-356-4848
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Fax | 408-356-4949
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Authorized Official
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Title or Position | PRESIDENT
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Name | TRINH CUONG
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Credential |
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Telephone | 408-356-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50586
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License Number State | CA
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