Provider Demographics
NPI:1427332121
Name:VU, ELLI (PHARM D)
Entity type:Individual
Prefix:
First Name:ELLI
Middle Name:
Last Name:VU
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 1:2665 N VISTA BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1752
Mailing Address - Country:US
Mailing Address - Phone:714-283-4227
Mailing Address - Fax:
Practice Address - Street 1:1201 E YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3830
Practice Address - Country:US
Practice Address - Phone:714-579-7451
Practice Address - Fax:714-579-7563
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 49290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist