Provider Demographics
NPI:1538341466
Name:QUANG, LINDA HUONG (PHARMD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:HUONG
Last Name:QUANG
Suffix:
Gender:F
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:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:PENNGROVE
Mailing Address - State:CA
Mailing Address - Zip Code:94951-0545
Mailing Address - Country:US
Mailing Address - Phone:707-338-9779
Mailing Address - Fax:
Practice Address - Street 1:401 BICENTENNIAL WAY STE 315
Practice Address - Street 2:ANTICOAGULATION CLINIC
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-571-3287
Practice Address - Fax:707-571-4815
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist