Provider Demographics
NPI:1376819128
Name:VU, KHANG D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KHANG
Middle Name:D
Last Name:VU
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 1:20801 LANCELOT LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-5932
Mailing Address - Country:US
Mailing Address - Phone:714-962-5218
Mailing Address - Fax:
Practice Address - Street 1:200 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3910
Practice Address - Country:US
Practice Address - Phone:714-893-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 549401835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy