Provider Demographics
NPI:1609168624
Name:TIEU, LINDA MY (RPH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MY
Last Name:TIEU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 PANAMA RD
Mailing Address - Street 2:
Mailing Address - City:LAMONT
Mailing Address - State:CA
Mailing Address - Zip Code:93241-1322
Mailing Address - Country:US
Mailing Address - Phone:661-845-6917
Mailing Address - Fax:661-845-6922
Practice Address - Street 1:8008 PANAMA RD
Practice Address - Street 2:
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1322
Practice Address - Country:US
Practice Address - Phone:661-845-6917
Practice Address - Fax:661-845-6922
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 62394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist