Healthcare Provider Details

I. General information

NPI: 1760914402
Provider Name (Legal Business Name): TRAM-ANH HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3552 CASSIS CT
SAN JOSE CA
95148-4391
US

IV. Provider business mailing address

3552 CASSIS CT
SAN JOSE CA
95148-4391
US

V. Phone/Fax

Practice location:
  • Phone: 408-238-2249
  • Fax:
Mailing address:
  • Phone: 408-238-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: