Provider Demographics
NPI:1124739495
Name:LA, RICHARD MINH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MINH
Last Name:LA
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 1:4050 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6907
Mailing Address - Country:US
Mailing Address - Phone:916-294-9566
Mailing Address - Fax:
Practice Address - Street 1:4050 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6907
Practice Address - Country:US
Practice Address - Phone:916-294-9566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA87379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist