Provider Demographics
NPI:1730463910
Name:FU, MINJUAN (PHARMACIST)
Entity type:Individual
Prefix:
First Name:MINJUAN
Middle Name:
Last Name:FU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30034 RAINBOW CREST DR
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4029
Mailing Address - Country:US
Mailing Address - Phone:818-585-2549
Mailing Address - Fax:
Practice Address - Street 1:30034 RAINBOW CREST DR
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4029
Practice Address - Country:US
Practice Address - Phone:818-585-2549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist