Provider Demographics
NPI:1962810903
Name:DIEP, THI TU (RPH)
Entity type:Individual
Prefix:
First Name:THI
Middle Name:TU
Last Name:DIEP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5600
Mailing Address - Country:US
Mailing Address - Phone:760-966-0143
Mailing Address - Fax:760-966-0259
Practice Address - Street 1:2100 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5600
Practice Address - Country:US
Practice Address - Phone:760-966-0143
Practice Address - Fax:760-966-0259
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist