Healthcare Provider Details

I. General information

NPI: 1477091494
Provider Name (Legal Business Name): DIANA HOANG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5248 VISTA DEL MAR
CYPRESS CA
90630-3048
US

IV. Provider business mailing address

5248 VISTA DEL MAR
CYPRESS CA
90630-3048
US

V. Phone/Fax

Practice location:
  • Phone: 714-622-9779
  • Fax:
Mailing address:
  • Phone: 714-622-9779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75428
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: