Organization
KIM TOAN T DO
Active
Other names
tana pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM-TOAN THI DO PHARMACIST (PHARMACIST OWNER IN CHARGE)
(714) 374-1383
Entity
Organization
Contact information
Practice address
10512 BOLSA AVE, STE 104, WESTMINSTER, CA 92683-6727
(714) 554-4121
(714) 554-2150
Mailing address
10512 BOLSA AVE, WESTMINSTER, CA 92683-6727
(714) 554-4121
(714) 554-2150
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY34579
CA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4354650001
MEDICARE ID
—
05
—
PHA345790
—
CA
Enumeration date
08/24/2005
Last updated
06/23/2022
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