Provider Demographics
NPI:1841550688
Name:VO, CHAU TRUNG (RPH)
Entity type:Individual
Prefix:MR
First Name:CHAU
Middle Name:TRUNG
Last Name:VO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11859 TRAIL CREST DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-6147
Mailing Address - Country:US
Mailing Address - Phone:858-405-6783
Mailing Address - Fax:
Practice Address - Street 1:4502 UNIVERSITY AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1895
Practice Address - Country:US
Practice Address - Phone:619-501-3245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-28
Last Update Date:2012-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist