Healthcare Provider Details

I. General information

NPI: 1659006583
Provider Name (Legal Business Name): HELENA THAI NHI HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2022
Last Update Date: 07/24/2022
Certification Date: 10/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E STE 803
LOS ANGELES CA
90067-2011
US

IV. Provider business mailing address

2691 KEPPLER DR
SAN JOSE CA
95148-2508
US

V. Phone/Fax

Practice location:
  • Phone: 424-535-1874
  • Fax: 213-315-4489
Mailing address:
  • Phone: 408-605-0987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH85448
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: