Healthcare Provider Details

I. General information

NPI: 1093953432
Provider Name (Legal Business Name): HAO HOANG PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/04/2024
Certification Date:
Deactivation Date: 05/25/2017
Reactivation Date: 11/14/2023

III. Provider practice location address

8112 SHELDON RD STE 300
ELK GROVE CA
95758
US

IV. Provider business mailing address

8112 SHELDON RD STE 300
ELK GROVE CA
95758
US

V. Phone/Fax

Practice location:
  • Phone: 916-684-9922
  • Fax: 916-684-9499
Mailing address:
  • Phone: 916-684-9922
  • Fax: 916-684-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH80683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: