Provider Demographics
NPI:1538569819
Name:DUONG, ROBERT (PHARM D)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10655 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4828
Mailing Address - Country:US
Mailing Address - Phone:916-361-0515
Mailing Address - Fax:916-361-0813
Practice Address - Street 1:10655 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4828
Practice Address - Country:US
Practice Address - Phone:916-361-0515
Practice Address - Fax:916-361-0813
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68457183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist