Provider Demographics
NPI:1366956211
Name:DANG, THI MINH (RPH)
Entity type:Individual
Prefix:
First Name:THI
Middle Name:MINH
Last Name:DANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 S SUNSET AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3962
Mailing Address - Country:US
Mailing Address - Phone:626-960-8696
Mailing Address - Fax:626-960-8749
Practice Address - Street 1:1250 S SUNSET AVE STE 207
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3962
Practice Address - Country:US
Practice Address - Phone:626-960-8696
Practice Address - Fax:626-960-8749
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-29
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty