Provider Demographics
NPI:1275641946
Name:HUYNH, THU J (RPH)
Entity Type:Individual
Prefix:
First Name:THU
Middle Name:J
Last Name:HUYNH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 TERRACE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6347
Mailing Address - Country:US
Mailing Address - Phone:707-562-8272
Mailing Address - Fax:707-562-8304
Practice Address - Street 1:3239 TERRACE BEACH DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-6347
Practice Address - Country:US
Practice Address - Phone:707-562-8272
Practice Address - Fax:707-562-8304
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist