Healthcare Provider Details

I. General information

NPI: 1114448875
Provider Name (Legal Business Name): THUY HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 PARKWAY DR
LA MESA CA
91942-2104
US

IV. Provider business mailing address

359 HUCKLEBERRY DR
SAN JOSE CA
95123-4446
US

V. Phone/Fax

Practice location:
  • Phone: 619-523-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number74880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: