Healthcare Provider Details

I. General information

NPI: 1023480266
Provider Name (Legal Business Name): THUONG HOANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANTHONY HOANG

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 BELL RD # 95603
AUBURN CA
95603-2508
US

IV. Provider business mailing address

2700 BELL RD # 95603
AUBURN CA
95603-2508
US

V. Phone/Fax

Practice location:
  • Phone: 530-889-5650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number73195
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: