Provider Demographics
NPI:1073813150
Name:VO, THIEN VAN VU (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THIEN VAN
Middle Name:VU
Last Name:VO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78271 HIGHWAY 111
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2063
Mailing Address - Country:US
Mailing Address - Phone:760-564-2225
Mailing Address - Fax:760-564-8791
Practice Address - Street 1:78271 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2063
Practice Address - Country:US
Practice Address - Phone:760-564-2225
Practice Address - Fax:760-564-8791
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 60666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist