Provider Demographics
NPI:1720633456
Name:TRINH, TU KHA
Entity Type:Individual
Prefix:
First Name:TU
Middle Name:KHA
Last Name:TRINH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5757 DOW AVE APT 505
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-5109
Mailing Address - Country:US
Mailing Address - Phone:703-657-9090
Mailing Address - Fax:
Practice Address - Street 1:5700 BOU AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1663
Practice Address - Country:US
Practice Address - Phone:301-945-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist