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General NPI Number Information
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NPI Number | 1790071512
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Entity Type | Individual
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Provider Name | KIMLIEN T DANG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1605 W 1ST ST STE A
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City | SANTA ANA
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State | CA
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Zip | 92703-3626
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Country | US
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Telephone | 714-486-3708
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Fax |
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Provider Business Mailing Address
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Address Line | 8848 CITRUS AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-5496
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Country | US
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Telephone | 714-797-0712
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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 | 49608
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License Number State | CA
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