Provider Demographics
NPI:1417226119
Name:HUYNH, TUNG DUC (PHARMD)
Entity Type:Individual
Prefix:
First Name:TUNG
Middle Name:DUC
Last Name:HUYNH
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 1:1359 WHISPERING WIND LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8664
Mailing Address - Country:US
Mailing Address - Phone:714-206-1779
Mailing Address - Fax:
Practice Address - Street 1:8917 TRAUTWEIN RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-9473
Practice Address - Country:US
Practice Address - Phone:951-776-0470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH60250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist