Healthcare Provider Details

I. General information

NPI: 1386050755
Provider Name (Legal Business Name): CAROLYN HOANG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 07/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 WILMINGTON AVE
LOS ANGELES CA
90059-2553
US

IV. Provider business mailing address

11750 WILMINGTON AVE
LOS ANGELES CA
90059-2553
US

V. Phone/Fax

Practice location:
  • Phone: 323-563-6635
  • Fax: 323-563-7531
Mailing address:
  • Phone: 323-563-6635
  • Fax: 323-563-7531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69289
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: