Provider Demographics
NPI:1508301409
Name:GU, FENG (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:FENG
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32054 CAMINO GUARDA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1029
Mailing Address - Country:US
Mailing Address - Phone:408-888-6672
Mailing Address - Fax:
Practice Address - Street 1:32054 CAMINO GUARDA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1029
Practice Address - Country:US
Practice Address - Phone:408-888-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist