Healthcare Provider Details

I. General information

NPI: 1114849544
Provider Name (Legal Business Name): DEMI DIEP DANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1726 SUPERIOR AVE
COSTA MESA CA
92627-3615
US

IV. Provider business mailing address

3881 HAMILTON ST
IRVINE CA
92614-6666
US

V. Phone/Fax

Practice location:
  • Phone: 949-629-9714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: