Healthcare Provider Details

I. General information

NPI: 1730473653
Provider Name (Legal Business Name): BONNIE TRUC HOANG LE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N ROSE DR
PLACENTIA CA
92870-7520
US

IV. Provider business mailing address

710 N ROSE DR
PLACENTIA CA
92870-7520
US

V. Phone/Fax

Practice location:
  • Phone: 714-524-6200
  • Fax: 714-524-6297
Mailing address:
  • Phone: 714-524-6200
  • Fax: 714-524-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number64554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: