Provider Demographics
NPI:1437616406
Name:FALAH, XUAN VU (PHARMD)
Entity Type:Individual
Prefix:
First Name:XUAN
Middle Name:VU
Last Name:FALAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:XUAN
Other - Middle Name:THI THANH
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 ELK GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4188
Mailing Address - Country:US
Mailing Address - Phone:916-683-0700
Mailing Address - Fax:
Practice Address - Street 1:4900 ELK GROVE BLVD
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758
Practice Address - Country:US
Practice Address - Phone:916-683-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist