Healthcare Provider Details

I. General information

NPI: 1720404734
Provider Name (Legal Business Name): YEN HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6006 LINCOLN AVE
CYPRESS CA
90630-5808
US

IV. Provider business mailing address

6006 LINCOLN AVE
CYPRESS CA
90630-5808
US

V. Phone/Fax

Practice location:
  • Phone: 714-821-0669
  • Fax: 714-821-1015
Mailing address:
  • Phone: 714-821-0669
  • Fax: 714-821-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number58274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: