Provider Demographics
NPI:1063125953
Name:DANG, DON QUY (PHARMD)
Entity type:Individual
Prefix:
First Name:DON
Middle Name:QUY
Last Name:DANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22942 RIDGE ROUTE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-3693
Mailing Address - Country:US
Mailing Address - Phone:949-215-5899
Mailing Address - Fax:949-215-3855
Practice Address - Street 1:22942 RIDGE ROUTE DR STE 104
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-3693
Practice Address - Country:US
Practice Address - Phone:949-215-5899
Practice Address - Fax:949-215-3855
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist