Healthcare Provider Details

I. General information

NPI: 1578072658
Provider Name (Legal Business Name): OLIVER KING HEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 ORANGETHORPE AVE
BUENA PARK CA
90621-3429
US

IV. Provider business mailing address

7530 ORANGETHORPE AVE
BUENA PARK CA
90621-3429
US

V. Phone/Fax

Practice location:
  • Phone: 714-676-0014
  • Fax:
Mailing address:
  • Phone: 714-676-0014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77406
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: