Healthcare Provider Details

I. General information

NPI: 1225651359
Provider Name (Legal Business Name): MICHELLE HOANG PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2020
Last Update Date: 05/23/2020
Certification Date: 05/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2858 LOKER AVE E STE 100
CARLSBAD CA
92010-6673
US

IV. Provider business mailing address

6802 JONATHAN AVE
CYPRESS CA
90630-4924
US

V. Phone/Fax

Practice location:
  • Phone: 877-445-6874
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number68515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: