Healthcare Provider Details

I. General information

NPI: 1790693539
Provider Name (Legal Business Name): HAO GIA DUONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9670 PROMINENT PT
COLORADO SPRINGS CO
80924-5000
US

IV. Provider business mailing address

9670 PROMINENT PT
COLORADO SPRINGS CO
80924-5000
US

V. Phone/Fax

Practice location:
  • Phone: 719-302-4267
  • Fax:
Mailing address:
  • Phone: 719-302-4267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA.0025720
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: