Provider Demographics
NPI:1740772516
Name:HUYNH, DIEN (RPH)
Entity Type:Individual
Prefix:DR
First Name:DIEN
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1898 SENTER RD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-2503
Mailing Address - Country:US
Mailing Address - Phone:408-964-0944
Mailing Address - Fax:
Practice Address - Street 1:575 N SANBORN RD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2246
Practice Address - Country:US
Practice Address - Phone:831-751-9319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA78467OtherBOARD OF PHARMACY