Provider Demographics
NPI:1487026597
Name:TRUONG, CHAU K (RPH)
Entity Type:Individual
Prefix:
First Name:CHAU
Middle Name:K
Last Name:TRUONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1128
Mailing Address - Country:US
Mailing Address - Phone:702-870-7271
Mailing Address - Fax:702-870-7659
Practice Address - Street 1:6310 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1128
Practice Address - Country:US
Practice Address - Phone:702-870-7271
Practice Address - Fax:702-870-7659
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16412183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist