Healthcare Provider Details

I. General information

NPI: 1700361342
Provider Name (Legal Business Name): DAO ANH HOA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2018
Last Update Date: 09/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E STETSON AVE
HEMET CA
92543-7139
US

IV. Provider business mailing address

110 E STETSON AVE
HEMET CA
92543-7139
US

V. Phone/Fax

Practice location:
  • Phone: 951-766-1618
  • Fax: 951-766-2849
Mailing address:
  • Phone: 951-766-1618
  • Fax: 951-766-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: