=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053474056
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE HOA DIEP-KWEI PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2006
-----------------------------------------------------
Last Update Date | 06/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4200 TRABUCO RD STE 190
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92620-3659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-861-3170
-----------------------------------------------------
Fax | 949-861-3179
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 38 TOWNSEND
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92620-3868
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-780-3537
-----------------------------------------------------
Fax | 949-679-7859
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH45800
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------