Healthcare Provider Details

I. General information

NPI: 1801906763
Provider Name (Legal Business Name): DAWN HOANG PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15600 N BLACK CANYON HWY C107
PHOENIX AZ
85053-4055
US

IV. Provider business mailing address

15600 N BLACK CANYON HWY C107
PHOENIX AZ
85053-4055
US

V. Phone/Fax

Practice location:
  • Phone: 602-896-0454
  • Fax: 480-357-4639
Mailing address:
  • Phone: 602-896-0454
  • Fax: 480-357-4639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4081
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: