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NPI Code Detail

MEDICARE: TIN PHAT PHARMACY INC

MEDICARE: TIN PHAT PHARMACY INC
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
13336C0003XCommunity/Retail PharmacyCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
205-32300OTHERCANCPDP PROVIDER

General Provider Information

NPI Number : 1699767061
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIN PHAT PHARMACY INC
Provider Business Mailing Address
First Line : 9081 BOLSA AVE
Second Line : # 108
City : WESTMINSTER
State : CA
Zip : 92683-5509
Country : US
Telephone Number : 714-379-5072
Fax Number : 714-379-5074
Provider Business Practice Location Address
First Line : 9081 BOLSA AVE
Second Line : # 108
City : WESTMINSTER
State : CA
Zip : 92683-5509
Country : US
Telephone Number : 714-379-5072
Fax Number : 714-379-5074
Authorized Official
Title or Position : PRESIDENT/ PHARMACIST IN CHARGE
Name : MRS. VIVIAN TO-NGA NGUYEN
Credential : PHARM D
Telephone Number : 714-379-5072
Provider Enumeration Date : 08/22/2005
Last Update Date : 12/05/2023

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Directions to “TIN PHAT PHARMACY INC ” Practice Location

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