Provider Demographics
NPI:1104030543
Name:DOAN, ANHUE THI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANHUE
Middle Name:THI
Last Name:DOAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:ANHUE
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2702 GOSFORD ROAD
Mailing Address - Street 2:APT C
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309
Mailing Address - Country:US
Mailing Address - Phone:661-374-1500
Mailing Address - Fax:
Practice Address - Street 1:2702 GOSFORD RD APT C
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-8865
Practice Address - Country:US
Practice Address - Phone:661-378-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0561894OtherNABP PROVIDER SERVICES
CA451580Medicaid
CA39872OtherPHARMACY LICENSE NUMBER