MEDICARE: VIET'S PHARMACY

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225210198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIET'S PHARMACY

Provider Business Mailing Address
First Line	:	4616 EL CAJON BLVD STE 6
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4426
Country	:	US
Telephone Number	:	619-563-8212
Fax Number	:	619-563-8211

Provider Business Practice Location Address
First Line	:	4616 EL CAJON BLVD STE 6
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4426
Country	:	US
Telephone Number	:	619-563-8212
Fax Number	:	619-563-8211

Authorized Official
Title or Position	:	OWNER
Name	:	DR. VIET THUC TRUONG
Credential	:
Telephone Number	:	619-563-8212

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	12/03/2007

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Directions to “VIET'S PHARMACY ” Practice Location

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