Provider Demographics
NPI:1427836774
Name:VO, SUMMER TRUCTHANH
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:TRUCTHANH
Last Name:VO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14151 FLOWER ST APT 11
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4711
Mailing Address - Country:US
Mailing Address - Phone:714-487-3294
Mailing Address - Fax:
Practice Address - Street 1:14151 FLOWER ST APT 11
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4711
Practice Address - Country:US
Practice Address - Phone:714-487-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH87821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist