Provider Demographics
NPI:1124882469
Name:VLN HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:VLN HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VANSON
Authorized Official - Middle Name:TRADZU
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-867-6595
Mailing Address - Street 1:12800 GARDEN GROVE BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-2008
Mailing Address - Country:US
Mailing Address - Phone:714-867-6595
Mailing Address - Fax:909-621-5732
Practice Address - Street 1:12800 GARDEN GROVE BLVD STE G
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2008
Practice Address - Country:US
Practice Address - Phone:714-867-6595
Practice Address - Fax:909-621-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59171OtherBOARD OF PHARMACY