Provider Demographics
NPI:1194000992
Name:TONG, VIVIAN VU (RPH)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:VU
Last Name:TONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10735 EL TIBURON AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3805
Mailing Address - Country:US
Mailing Address - Phone:714-489-3885
Mailing Address - Fax:
Practice Address - Street 1:11750 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-3938
Practice Address - Country:US
Practice Address - Phone:562-693-6003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist