Provider Demographics
NPI:1215040217
Name:CHAU, TONY TOT VAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TONY TOT
Middle Name:VAN
Last Name:CHAU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:TOT
Other - Middle Name:VAN
Other - Last Name:CHAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7726 E WALNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-6515
Mailing Address - Country:US
Mailing Address - Phone:909-825-7084
Mailing Address - Fax:909-777-3849
Practice Address - Street 1:11201 BENTON ST
Practice Address - Street 2:ROUTE 119
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92357-1000
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:909-777-3849
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS307371835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist