Tully Clinic Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY35754 Issued in CA

Legal business name

TULLY CLINIC PHARMACY

Doing business as

TULLY MEDICAL CLINIC PHARMACY

Practice address

1693 Flanigan Dr
Ste 104
San Jose, CA 95121-1683

Phone

(408) 274-6698

Fax

(408) 274-8580

NPI assigned

Feb 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dai Vo

Title

Pic and President

Phone

(408) 274-6698

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TULLY MEDICAL CLINIC PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1689700080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1693 FLANIGAN DR",
            "address_2": "STE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211683",
            "telephone_number": "408-274-6698",
            "fax_number": "408-274-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1693 FLANIGAN DR",
            "address_2": "STE 104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951211683",
            "telephone_number": "408-274-6698",
            "fax_number": "408-274-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLY CLINIC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "DAI",
        "authorized_official_title_or_position": "PIC AND PRESIDENT",
        "authorized_official_telephone_number": "408-274-6698"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY35754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0598536",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA357540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TULLY MEDICAL CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neeharika Tuladhar
• Mikaya Branae Tulchinsky
• Patricia Lynne Tulee
• Stephen Gilligan Tull
• Leah Nicole Tullo, BA
• Tung T. Nguyen, D.O., Inc.
• Arthur Tung
• Denise Tung, ATC
• Emily Yi Tung, O.D.
• Tien N Tuong

• Community/Retail Pharmacy in San Jose, CA
• Providers in San Jose, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.