Healthcare Provider Details

I. General information

NPI: 1629380431
Provider Name (Legal Business Name): HONGNGOC THI HOANG PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 STEARN ST
LONG BEACH CA
90815
US

IV. Provider business mailing address

5545 E STEARNS ST
LONG BEACH CA
90815-3125
US

V. Phone/Fax

Practice location:
  • Phone: 562-596-8690
  • Fax:
Mailing address:
  • Phone: 562-596-8690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: