Provider Demographics
NPI:1780247049
Name:QUACH, JOSEPH TIEU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TIEU
Last Name:QUACH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:DY
Other - Middle Name:
Other - Last Name:QUACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12100 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2514
Mailing Address - Country:US
Mailing Address - Phone:818-763-5562
Mailing Address - Fax:818-763-5767
Practice Address - Street 1:12100 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2514
Practice Address - Country:US
Practice Address - Phone:818-763-5562
Practice Address - Fax:818-763-5767
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-22
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist