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NPI Code Detail

MEDICARE: DR. LUONG VINH THAI PHARM.D.

MEDICARE: DR. LUONG VINH THAI 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
1183500000XPharmacist72037CA

General Provider Information

NPI Number : 1457757650
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUONG VINH THAI PHARM.D.
Provider Business Mailing Address
First Line : 1661 10TH AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94122-3624
Country : US
Telephone Number : 626-537-7923
Fax Number :
Provider Business Practice Location Address
First Line : 1630 OCEAN AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94112-1718
Country : US
Telephone Number : 415-239-0804
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2014
Last Update Date : 11/15/2014

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