Provider Demographics
NPI:1447639380
Name:PHAM, HUONG QUYNH (PHARM D)
Entity type:Individual
Prefix:
First Name:HUONG
Middle Name:QUYNH
Last Name:PHAM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 VALLEY VIEW ST
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-3562
Mailing Address - Country:US
Mailing Address - Phone:714-947-9980
Mailing Address - Fax:
Practice Address - Street 1:8880 VALLEY VIEW ST
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3562
Practice Address - Country:US
Practice Address - Phone:714-947-9980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist