Basic Information
Provider Information
NPI: 1568072403
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOU
FirstName: EMILY
MiddleName: WIN
NamePrefix: DR.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 38885 HAYES ST
Address2:  
City: FREMONT
State: CA
PostalCode: 945364308
CountryCode: US
TelephoneNumber: 5108965679
FaxNumber:  
Practice Location
Address1: 751 S BASCOM AVE
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951282604
CountryCode: US
TelephoneNumber: 4088855000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2020
LastUpdateDate: 08/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XRPH81587CAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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