Healthcare Provider Details

I. General information

NPI: 1386101616
Provider Name (Legal Business Name): LAURA LAM HOANG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA LAM HO

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 BEL AIRE PLZ
NAPA CA
94558-2835
US

IV. Provider business mailing address

1731 APPLE DR
CONCORD CA
94518-3106
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-0975
  • Fax:
Mailing address:
  • Phone: 408-582-3488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number80247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: