Provider Demographics
NPI:1720144603
Name:D-PROFESSIONAL RX INC
Entity Type:Organization
Organization Name:D-PROFESSIONAL RX INC
Other - Org Name:D PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:TUONG
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:714-841-6700
Mailing Address - Street 1:9114 EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1437
Mailing Address - Country:US
Mailing Address - Phone:714-841-6700
Mailing Address - Fax:714-841-6788
Practice Address - Street 1:9114 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-1437
Practice Address - Country:US
Practice Address - Phone:714-841-6700
Practice Address - Fax:714-841-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY58810OtherBOARD OF PHARMACY
CAPHY50473OtherRETAIL PHARMACY PERMIT
CAPHY50473OtherRETAIL PHARMACY PERMIT