Provider Demographics
NPI:1174752117
Name:HUYNH, MYPHUONG THI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MYPHUONG
Middle Name:THI
Last Name:HUYNH
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 1:10371 GREENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-5016
Mailing Address - Country:US
Mailing Address - Phone:510-562-0312
Mailing Address - Fax:
Practice Address - Street 1:10371 GREENVIEW DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5016
Practice Address - Country:US
Practice Address - Phone:510-562-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH47783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist