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General NPI Number Information
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NPI Number | 1700799053
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Entity Type | Individual
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Provider Name | JACK VO
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Gender | Male
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2020 SANTA MONICA BLVD STE 600
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City | SANTA MONICA
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State | CA
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Zip | 90404-2131
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Country | US
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Telephone | 310-633-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 W 19TH ST
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City | UPLAND
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State | CA
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Zip | 91784-7433
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Country | US
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Telephone | 909-358-5390
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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 | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 91497
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License Number State | CA
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