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General NPI Number Information
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NPI Number | 1497219638
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Entity Type | Individual
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Provider Name | QUOC LUONG PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 3044 TULARE ST
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City | FRESNO
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State | CA
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Zip | 93721-1473
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Country | US
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Telephone | 559-266-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 E VIA ROMA DR
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City | FRESNO
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State | CA
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Zip | 93730-8800
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Country | US
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Telephone | 559-916-4854
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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 | 65421
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License Number State | CA
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