Provider Demographics
NPI:1053852996
Name:QUACH, CHAU (RPH)
Entity Type:Individual
Prefix:
First Name:CHAU
Middle Name:
Last Name:QUACH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 GOLDEN WEST AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2518
Mailing Address - Country:US
Mailing Address - Phone:626-292-6977
Mailing Address - Fax:
Practice Address - Street 1:5520 GOLDEN WEST AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2518
Practice Address - Country:US
Practice Address - Phone:626-292-6977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-11
Last Update Date:2017-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist