Provider Demographics
NPI:1043090996
Name:LA, THANG QUOC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THANG
Middle Name:QUOC
Last Name:LA
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 1:502 EUCLID AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2948
Mailing Address - Country:US
Mailing Address - Phone:619-399-7581
Mailing Address - Fax:866-499-6601
Practice Address - Street 1:502 EUCLID AVE STE 100
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2948
Practice Address - Country:US
Practice Address - Phone:619-399-7581
Practice Address - Fax:866-499-6601
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH62873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist