Provider Demographics
NPI:1780935478
Name:QUACH, SAN PHOI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:SAN
Middle Name:PHOI
Last Name:QUACH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:SAU
Other - Middle Name:PHOI
Other - Last Name:QUACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:10635 FOLSOM BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670
Mailing Address - Country:US
Mailing Address - Phone:916-364-4944
Mailing Address - Fax:916-364-4949
Practice Address - Street 1:10635 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4828
Practice Address - Country:US
Practice Address - Phone:916-364-4944
Practice Address - Fax:916-364-4949
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist