Provider Demographics
NPI:1598197154
Name:HUYNH, TONY DUC (PHARMD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:DUC
Last Name:HUYNH
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 1:2034 E 19TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-4667
Mailing Address - Country:US
Mailing Address - Phone:510-967-3890
Mailing Address - Fax:
Practice Address - Street 1:2034 E 19TH ST APT 4
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-4667
Practice Address - Country:US
Practice Address - Phone:510-967-3890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist