Provider Demographics
NPI:1558834101
Name:LUONG, VINCENT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:LUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 S TOWNER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3863
Mailing Address - Country:US
Mailing Address - Phone:714-656-7781
Mailing Address - Fax:
Practice Address - Street 1:600 CITY PKWY W STE 800
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2948
Practice Address - Country:US
Practice Address - Phone:714-796-5934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist