Healthcare Provider Details

I. General information

NPI: 1740508043
Provider Name (Legal Business Name): ALICE P HOANG PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6075 MAGNOLIA AVE
RIVERSIDE CA
92506-2525
US

IV. Provider business mailing address

18608 CALLENS CIR
FOUNTAIN VALLEY CA
92708-6626
US

V. Phone/Fax

Practice location:
  • Phone: 951-682-0177
  • Fax:
Mailing address:
  • Phone: 714-593-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH 56761
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: