Healthcare Provider Details

I. General information

NPI: 1689949786
Provider Name (Legal Business Name): HONGCAM THI DUONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2661 GREEN RIVER RD
CORONA CA
92882-7401
US

IV. Provider business mailing address

2661 GREEN RIVER RD
CORONA CA
92882-7401
US

V. Phone/Fax

Practice location:
  • Phone: 951-371-4868
  • Fax: 951-371-6542
Mailing address:
  • Phone: 951-371-4868
  • Fax: 951-371-6542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: