Provider Demographics
NPI:1447567326
Name:HUYNH, WANDA O (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:WANDA
Middle Name:O
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10841 FLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-3023
Mailing Address - Country:US
Mailing Address - Phone:714-728-3604
Mailing Address - Fax:
Practice Address - Street 1:4322 S FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2642
Practice Address - Country:US
Practice Address - Phone:323-235-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist