Provider Demographics
NPI:1417690074
Name:HUYNH, DANA THANHA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:THANHA
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 GREEN LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-1848
Mailing Address - Country:US
Mailing Address - Phone:310-465-5516
Mailing Address - Fax:
Practice Address - Street 1:3007 GREEN LN
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-1848
Practice Address - Country:US
Practice Address - Phone:310-465-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist