Provider Demographics
NPI:1992026645
Name:QUACH, KATHRYN DIEP (PHARM D)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DIEP
Last Name:QUACH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 STRANAHAN DR
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-4426
Mailing Address - Country:US
Mailing Address - Phone:626-281-9143
Mailing Address - Fax:
Practice Address - Street 1:3570 SANTA ANITA AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2456
Practice Address - Country:US
Practice Address - Phone:626-442-9238
Practice Address - Fax:626-442-0870
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist