Provider Demographics
NPI:1083007967
Name:DUONG, PETER Q (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:Q
Last Name:DUONG
Suffix:
Gender:M
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 1:8201 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-1500
Mailing Address - Country:US
Mailing Address - Phone:714-369-0372
Mailing Address - Fax:
Practice Address - Street 1:8201 STERLING DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-1500
Practice Address - Country:US
Practice Address - Phone:714-369-0372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist