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General NPI Number Information
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NPI Number | 1740501147
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Entity Type | Individual
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Provider Name | THERESA HOANG THUY BACH PHARMD.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2010
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Last Update Date | 06/20/2010
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Provider Practice Location Address
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Address Line | 121 S RANCHO SANTA FE RD
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City | SAN MARCOS
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State | CA
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Zip | 92078-2501
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Country | US
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Telephone | 760-744-2583
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Fax |
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Provider Business Mailing Address
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Address Line | 776 AVENIDA ABEJA
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City | SAN MARCOS
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State | CA
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Zip | 92069-7343
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Country | US
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Telephone | 760-580-8353
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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 | 56751
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License Number State | CA
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