Provider Demographics
NPI:1992005888
Name:KIEU, DAVID DONG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DONG
Last Name:KIEU
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 1:9460 N NAME UNO STE 100
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3536
Mailing Address - Country:US
Mailing Address - Phone:408-842-2001
Mailing Address - Fax:408-842-7141
Practice Address - Street 1:9460 N NAME UNO STE 100
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3536
Practice Address - Country:US
Practice Address - Phone:408-842-2001
Practice Address - Fax:408-842-7141
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist