Healthcare Provider Details

I. General information

NPI: 1235459934
Provider Name (Legal Business Name): MISS CHRISTINA HONG HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S GAFFEY ST
SAN PEDRO CA
90731-2437
US

IV. Provider business mailing address

15831 CLARENDON ST
WESTMINSTER CA
92683-6938
US

V. Phone/Fax

Practice location:
  • Phone: 310-831-9167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number51374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: