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General NPI Number Information
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NPI Number | 1972596062
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Entity Type | Organization
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Legal Business Name | KIM TOAN T DO
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 10512 BOLSA AVE STE 104
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City | WESTMINSTER
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State | CA
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Zip | 92683-6727
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Country | US
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Telephone | 714-554-4121
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Fax | 714-554-2150
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Provider Business Mailing Address
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Address Line | 10512 BOLSA AVE
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City | WESTMINSTER
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State | CA
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Zip | 92683-6727
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Country | US
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Telephone | 714-554-4121
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Fax | 714-554-2150
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Authorized Official
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Title or Position | PHARMACIST OWNER IN CHARGE
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Name | MRS. KIM-TOAN THI DO
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Credential | PHARMACIST
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Telephone | 714-374-1383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY34579
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License Number State | CA
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