Provider Demographics
NPI:1972040988
Name:CHAN, ANGELA VU (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:VU
Last Name:CHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:450 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4304
Mailing Address - Country:US
Mailing Address - Phone:415-626-4341
Mailing Address - Fax:415-437-9438
Practice Address - Street 1:450 10TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4304
Practice Address - Country:US
Practice Address - Phone:415-626-4341
Practice Address - Fax:415-437-9438
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist