Provider Demographics
NPI:1750674701
Name:VU, THU THI
Entity Type:Individual
Prefix:MS
First Name:THU
Middle Name:THI
Last Name:VU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 ALMADEN EXPY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3603
Mailing Address - Country:US
Mailing Address - Phone:408-979-2518
Mailing Address - Fax:408-979-2527
Practice Address - Street 1:5301 ALMADEN EXPY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3603
Practice Address - Country:US
Practice Address - Phone:408-979-2518
Practice Address - Fax:408-979-2527
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA49153OtherPHARMACIST LICENSE NUMBER