Provider Demographics
NPI:1437142221
Name:HUYNH, LAM TRUC (RPH)
Entity Type:Individual
Prefix:
First Name:LAM
Middle Name:TRUC
Last Name:HUYNH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 WESTMINSTER AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4984
Mailing Address - Country:US
Mailing Address - Phone:714-537-0325
Mailing Address - Fax:714-537-9456
Practice Address - Street 1:10900 WESTMINSTER AVE
Practice Address - Street 2:STE 1
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4984
Practice Address - Country:US
Practice Address - Phone:714-537-0325
Practice Address - Fax:714-537-9456
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2008-09-23
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-10
Provider Licenses
StateLicense IDTaxonomies
CAPHY36932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124280002Medicare NSC