Provider Demographics
NPI:1003223025
Name:VU, QUANG (PHARMD)
Entity Type:Individual
Prefix:
First Name:QUANG
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E IMPERIAL HWY
Mailing Address - Street 2:WALMART PHARMACY MANAGER
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7452
Mailing Address - Country:US
Mailing Address - Phone:714-869-0539
Mailing Address - Fax:714-869-0531
Practice Address - Street 1:1000 E IMPERIAL HWY
Practice Address - Street 2:WALMART PHARMACY MANAGER
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7452
Practice Address - Country:US
Practice Address - Phone:714-869-0539
Practice Address - Fax:714-869-0531
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 57205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist