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NPI Code Detail

MEDICARE: DUNG DOAN PHARM D

MEDICARE: DUNG DOAN PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist55839CA

General Provider Information

NPI Number : 1063798643
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUNG DOAN PHARM D
Provider Business Mailing Address
First Line : 1344 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3356
Country : US
Telephone Number : 310-353-5726
Fax Number : 310-373-5770
Provider Business Practice Location Address
First Line : 1344 W REDONDO BEACH BLVD
Second Line :
City : GARDENA
State : CA
Zip : 90247-3356
Country : US
Telephone Number : 310-353-5726
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2011
Last Update Date : 10/27/2011

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Directions to “ DUNG DOAN PHARM D” Practice Location

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