Healthcare Provider Details

I. General information

NPI: 1023695921
Provider Name (Legal Business Name): NINA HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 LINCOLN WAY
GARDEN GROVE CA
92841-1428
US

IV. Provider business mailing address

20620 VIA SUSANNAH
YORBA LINDA CA
92887-3112
US

V. Phone/Fax

Practice location:
  • Phone: 800-228-3643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number73753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: