Provider Demographics
NPI:1699862110
Name:VU, JENNIFER XUAN-THU (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:XUAN-THU
Last Name:VU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 N EUCLID AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3456
Mailing Address - Country:US
Mailing Address - Phone:909-983-0999
Mailing Address - Fax:909-983-0888
Practice Address - Street 1:437 N EUCLID AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3456
Practice Address - Country:US
Practice Address - Phone:909-983-0999
Practice Address - Fax:909-983-0888
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 55233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist