Healthcare Provider Details

I. General information

NPI: 1518736057
Provider Name (Legal Business Name): HUY QUOC HOANG PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2023
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12540 MCCANN DR
SANTA FE SPRINGS CA
90670-3337
US

IV. Provider business mailing address

15231 EDEN ST
WESTMINSTER CA
92683-5472
US

V. Phone/Fax

Practice location:
  • Phone: 714-664-0518
  • Fax: 714-664-0680
Mailing address:
  • Phone: 714-837-5846
  • Fax: 714-664-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54830
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: