Provider Demographics
NPI:1902489321
Name:VO, ERIC QUANG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:QUANG
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 1:12280 PERRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7418
Mailing Address - Country:US
Mailing Address - Phone:951-242-3596
Mailing Address - Fax:951-247-3694
Practice Address - Street 1:12280 PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-7418
Practice Address - Country:US
Practice Address - Phone:951-242-3596
Practice Address - Fax:951-247-3694
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-03
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82373183500000X
CARPH82373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist