Healthcare Provider Details

I. General information

NPI: 1578221768
Provider Name (Legal Business Name): ANGELA TAO-HUI FENG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2021
Last Update Date: 12/04/2021
Certification Date: 12/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5147 MOUNT HELENA AVE
LOS ANGELES CA
90041-2330
US

IV. Provider business mailing address

5147 MOUNT HELENA AVE
LOS ANGELES CA
90041-2330
US

V. Phone/Fax

Practice location:
  • Phone: 510-501-4461
  • Fax:
Mailing address:
  • Phone: 510-501-4461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number64135
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number7151990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: