Provider Demographics
NPI:1114203825
Name:DO, VONG H (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:VONG
Middle Name:H
Last Name:DO
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 1:530 N RURAL DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-1323
Mailing Address - Country:US
Mailing Address - Phone:626-512-8974
Mailing Address - Fax:
Practice Address - Street 1:8900 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3765
Practice Address - Country:US
Practice Address - Phone:562-222-1590
Practice Address - Fax:562-222-1642
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH55973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist