Provider Demographics
NPI:1326854621
Name:VO, ANDREW DANG HUAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:DANG HUAN
Last Name:VO
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 1:4550 LAKESHORE BLVD APT 3
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-6240
Mailing Address - Country:US
Mailing Address - Phone:408-987-1454
Mailing Address - Fax:
Practice Address - Street 1:1071 11TH ST
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-4105
Practice Address - Country:US
Practice Address - Phone:707-263-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist