Provider Demographics
NPI:1700288503
Name:VUONG, LARRY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:VUONG
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 1:6243 LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3922
Mailing Address - Country:US
Mailing Address - Phone:916-849-7434
Mailing Address - Fax:
Practice Address - Street 1:6243 LANDIS AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3922
Practice Address - Country:US
Practice Address - Phone:916-849-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71449183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist