Provider Demographics
NPI:1619152386
Name:DANG, TAMMINH THI (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:TAMMINH
Middle Name:THI
Last Name:DANG
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 280
Mailing Address - Street 2:
Mailing Address - City:ATWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:92811-0280
Mailing Address - Country:US
Mailing Address - Phone:714-321-5086
Mailing Address - Fax:
Practice Address - Street 1:801 E KATELLA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6606
Practice Address - Country:US
Practice Address - Phone:714-533-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH46793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist