Healthcare Provider Details

I. General information

NPI: 1013427392
Provider Name (Legal Business Name): DR. BRIAN VIET HOANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BRIAN VIET HOANG PHARMD

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 10/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8470 ELK GROVE BLVD STE 150
ELK GROVE CA
95758-5925
US

IV. Provider business mailing address

8470 ELK GROVE BLVD STE 150
ELK GROVE CA
95758-5925
US

V. Phone/Fax

Practice location:
  • Phone: 916-667-3852
  • Fax: 916-896-5194
Mailing address:
  • Phone: 916-667-3852
  • Fax: 916-896-5194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: