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General NPI Number Information
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NPI Number | 1467933150
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Entity Type | Individual
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Provider Name | NGOC QUYEN THI LUONG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 30600 DYER ST
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City | UNION CITY
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State | CA
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Zip | 94587-1717
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Country | US
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Telephone | 408-667-7260
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 E CAPITOL EXPY SPC 17
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City | SAN JOSE
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State | CA
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Zip | 95121-1811
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Country | US
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Telephone | 408-667-7260
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 77953
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License Number State | CA
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