Healthcare Provider Details

I. General information

NPI: 1750753711
Provider Name (Legal Business Name): STEVE SON HONG HOANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SON HONG HOANG

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16750 W BELL RD
SURPRISE AZ
85374-9539
US

IV. Provider business mailing address

11929 W CYPRESS ST
AVONDALE AZ
85392-3094
US

V. Phone/Fax

Practice location:
  • Phone: 623-546-8246
  • Fax:
Mailing address:
  • Phone: 714-360-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021268
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: