Provider Demographics
NPI:1215205737
Name:DUONG, AMY C (PHARM D)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:DUONG
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 1:440 BLOSSOM HILL RD.
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1608
Mailing Address - Country:US
Mailing Address - Phone:408-229-8013
Mailing Address - Fax:408-229-8346
Practice Address - Street 1:440 BLOSSOM HILL RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1608
Practice Address - Country:US
Practice Address - Phone:408-229-8013
Practice Address - Fax:408-229-8346
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist