Individual
ANNIE THAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
14629 7TH ST, VICTORVILLE, CA 92395-4019
(760) 245-6600
Mailing address
736 E MANDEVILLA WAY, AZUSA, CA 91702-1492
(626) 632-5836
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0024183
CO
183500000X
Pharmacist
Primary
87240
CA
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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