Provider Demographics
NPI:1275995086
Name:DUONG, THOMAS N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:DUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 N EUCLID ST STE B
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-4617
Mailing Address - Country:US
Mailing Address - Phone:714-533-3080
Mailing Address - Fax:714-533-3090
Practice Address - Street 1:621 N EUCLID ST
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-4615
Practice Address - Country:US
Practice Address - Phone:714-533-3080
Practice Address - Fax:714-533-3090
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist