Provider Demographics
NPI:1124537261
Name:VU, NINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:VU
Suffix:
Gender:F
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 1:14416 PLUM LN APT 3
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-5960
Mailing Address - Country:US
Mailing Address - Phone:562-842-9787
Mailing Address - Fax:
Practice Address - Street 1:14416 PLUM LANE
Practice Address - Street 2:UNIT 3
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:562-842-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77300OtherCALIFORNIA BOARD OF PHARMACY