Healthcare Provider Details

I. General information

NPI: 1578990925
Provider Name (Legal Business Name): RICHARD HO DANG PHARMD, BCACP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 SAN PABLO ST #144
LOS ANGELES CA
90033-5320
US

IV. Provider business mailing address

1510 SAN PABLO ST STE 144
LOS ANGELES CA
90033-5394
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-5992
  • Fax: 323-442-5916
Mailing address:
  • Phone: 323-442-5992
  • Fax: 323-442-5916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69784
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number69784
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number69784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: