Provider Demographics
NPI:1689395162
Name:VANG, KATE NGUYEN UYEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:NGUYEN UYEN
Last Name:VANG
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 1:10921 RUSTIC LN
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6357
Mailing Address - Country:US
Mailing Address - Phone:714-331-6410
Mailing Address - Fax:
Practice Address - Street 1:101 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1011
Practice Address - Country:US
Practice Address - Phone:714-422-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist