Provider Demographics
NPI:1396007233
Name:VU, THAO THACH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:THACH
Last Name:VU
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 1:3118 STEVENS LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3624
Mailing Address - Country:US
Mailing Address - Phone:408-391-3088
Mailing Address - Fax:
Practice Address - Street 1:1993 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1406
Practice Address - Country:US
Practice Address - Phone:408-254-6392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55995183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist