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General NPI Number Information
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NPI Number | 1952398117
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Entity Type | Organization
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Legal Business Name | TAO DAN PHARMACY, INC.
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 15342 MONTPELLIER AVE
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City | IRVINE
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State | CA
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Zip | 92604-3130
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Country | US
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Telephone | 714-323-3864
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Fax |
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Provider Business Mailing Address
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Address Line | 15342 MONTPELLIER AVE
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City | IRVINE
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State | CA
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Zip | 92604-3130
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Country | US
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Telephone | 714-323-3864
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ PHARMACIST IN CHARGE
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Name | MRS. DUNG THU NGUYEN
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Credential | PHARM.D
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Telephone | 714-323-3864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY47231
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License Number State | CA
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