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General NPI Number Information
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NPI Number | 1396034591
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Entity Type | Organization
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Legal Business Name | THERESA PHARMACY INC
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 9860 KATELLA AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-6418
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Country | US
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Telephone | 714-534-4633
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Fax | 714-534-2889
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Provider Business Mailing Address
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Address Line | 9860 KATELLA AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-6418
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Country | US
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Telephone | 714-534-4633
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Fax | 714-534-2889
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Authorized Official
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Title or Position | PRESIDENT/PIC
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Name | MRS. ELISE BICH UYENDANG NGUYEN
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Credential | RPH
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Telephone | 714-534-4633
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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 | PHY50616
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License Number State | CA
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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 | PHY50616
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License Number State | CA
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