Provider Demographics
NPI:1063576783
Name:VO, THUY T (PHARM D)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:T
Last Name:VO
Suffix:
Gender:F
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 1:16213 PAUHASICA RD.
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308
Mailing Address - Country:US
Mailing Address - Phone:760-240-4714
Mailing Address - Fax:760-843-2095
Practice Address - Street 1:14011 PARK AVE
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-2413
Practice Address - Country:US
Practice Address - Phone:760-843-2072
Practice Address - Fax:760-843-2095
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 42811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist