Provider Demographics
NPI:1487193025
Name:TU, KINH VAN (RPH)
Entity Type:Individual
Prefix:DR
First Name:KINH
Middle Name:VAN
Last Name:TU
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 1:2656 1/2 DELTA AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3221
Mailing Address - Country:US
Mailing Address - Phone:626-616-6434
Mailing Address - Fax:
Practice Address - Street 1:2656 1/2 DELTA AVE
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-3221
Practice Address - Country:US
Practice Address - Phone:626-616-6434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist