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General NPI Number Information
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NPI Number | 1043688765
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Entity Type | Individual
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Provider Name | AILEEN D QUACH PHARM D
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Gender | Female
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 2700 LAS POSITAS RD
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City | LIVERMORE
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State | CA
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Zip | 94551-9619
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Country | US
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Telephone | 925-455-0215
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Fax |
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Provider Business Mailing Address
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Address Line | 10447 EL PASO WAY
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City | STOCKTON
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State | CA
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Zip | 95209-4253
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Country | US
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Telephone | 209-598-2358
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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 | RPH 55140
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License Number State | CA
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