Provider Demographics
NPI:1598851214
Name:TANG, ALICE QUYNH (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:QUYNH
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 BELLA CALAIS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1329
Mailing Address - Country:US
Mailing Address - Phone:408-629-5592
Mailing Address - Fax:
Practice Address - Street 1:496 BELLA CALAIS WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1329
Practice Address - Country:US
Practice Address - Phone:408-629-5592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist