MEDICARE: LOUISE QUACH

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	183500000X	Pharmacist	70316	CA

General Provider Information

NPI Number	:	1316369747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE QUACH

Provider Business Mailing Address
First Line	:	1311 VIA DONDERA
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-3674
Country	:	US
Telephone Number	:	408-655-2175
Fax Number	:

Provider Business Practice Location Address
First Line	:	533 COLEMAN AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95110-2047
Country	:	US
Telephone Number	:	408-346-2023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2014
Last Update Date	:	01/21/2014

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Directions to “ LOUISE QUACH ” Practice Location

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