Provider Demographics
NPI:1881977494
Name:HA, VINH QUOC (PHARM D)
Entity type:Individual
Prefix:
First Name:VINH
Middle Name:QUOC
Last Name:HA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 SUNBURST DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-2267
Mailing Address - Country:US
Mailing Address - Phone:408-629-6691
Mailing Address - Fax:
Practice Address - Street 1:1988 FREEDOM BLVD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-2837
Practice Address - Country:US
Practice Address - Phone:831-724-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist