Healthcare Provider Details

I. General information

NPI: 1710543145
Provider Name (Legal Business Name): VINH D HOANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 E CHASE AVE
EL CAJON CA
92020-6409
US

IV. Provider business mailing address

10583 GIFFIN WAY
SAN DIEGO CA
92126-3049
US

V. Phone/Fax

Practice location:
  • Phone: 619-447-1069
  • Fax: 619-447-4629
Mailing address:
  • Phone: 858-842-0858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75110
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: