MEDICARE: DIANA HOANG PHARM. D.

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	14224	NV

General Provider Information

NPI Number	:	1780035402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA HOANG PHARM. D.

Provider Business Mailing Address
First Line	:	4345 FRENCH LANDING RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4249
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5940 LOSEE RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6591
Country	:	US
Telephone Number	:	702-639-9002
Fax Number	:

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

Provider Enumeration Date	:	06/23/2016
Last Update Date	:	06/23/2016

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