Healthcare Provider Details

I. General information

NPI: 1346179108
Provider Name (Legal Business Name): OANH THI HOANG NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26520 CACTUS AVE
MORENO VALLEY CA
92555-3927
US

IV. Provider business mailing address

2119 W MERCED AVE
WEST COVINA CA
91790-2533
US

V. Phone/Fax

Practice location:
  • Phone: 626-242-3529
  • Fax:
Mailing address:
  • Phone: 626-242-3529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH91293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: