MEDICARE: HAO NHU DOAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	50112	CA

General Provider Information

NPI Number	:	1396064259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAO NHU DOAN

Provider Business Mailing Address
First Line	:	23 PENINSULA CTR
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:	310-377-4472
Fax Number	:	310-377-2313

Provider Business Practice Location Address
First Line	:	23 PENINSULA CTR
Second Line	:
City	:	ROLLING HILLS ESTATES
State	:	CA
Zip	:	90274-3506
Country	:	US
Telephone Number	:	310-377-4472
Fax Number	:	310-377-2313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	05/18/2010

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Directions to “ HAO NHU DOAN ” Practice Location

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