Provider Demographics
NPI:1194248005
Name:LUU, THANH KIM (PHARMD)
Entity type:Individual
Prefix:
First Name:THANH
Middle Name:KIM
Last Name:LUU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4013
Mailing Address - Country:US
Mailing Address - Phone:925-743-0166
Mailing Address - Fax:925-743-0796
Practice Address - Street 1:611 SAN RAMON VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4013
Practice Address - Country:US
Practice Address - Phone:925-743-0166
Practice Address - Fax:925-743-0796
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist