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General NPI Number Information
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NPI Number | 1124882469
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Entity Type | Organization
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Legal Business Name | VLN HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 12800 GARDEN GROVE BLVD STE G
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2008
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Country | US
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Telephone | 714-867-6595
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Fax | 909-621-5732
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Provider Business Mailing Address
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Address Line | 12800 GARDEN GROVE BLVD STE G
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City | GARDEN GROVE
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State | CA
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Zip | 92843-2008
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Country | US
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Telephone | 714-867-6595
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Fax | 909-621-5732
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | VANSON TRADZU LUU
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Credential | PHARM D
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Telephone | 714-867-6595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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