Provider Demographics
NPI:1902402902
Name:DANG, MINH CAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:CAM
Last Name:DANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CORNING AVE
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5228
Mailing Address - Country:US
Mailing Address - Phone:408-649-9473
Mailing Address - Fax:
Practice Address - Street 1:227 SHORELINE HWY
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3678
Practice Address - Country:US
Practice Address - Phone:415-380-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist