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General NPI Number Information
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NPI Number | 1356596241
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Entity Type | Organization
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Legal Business Name | HAO HOANG
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 12/24/2008
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Provider Practice Location Address
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Address Line | 9390 BIG HORN BLVD STE 110
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City | ELK GROVE
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State | CA
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Zip | 95758-7978
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Country | US
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Telephone | 916-684-9922
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Fax |
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Provider Business Mailing Address
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Address Line | 9390 BIG HORN BLVD STE 110
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City | ELK GROVE
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State | CA
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Zip | 95758-7978
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAO HOANG
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Credential |
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Telephone | 916-529-6722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY49263
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License Number State | CA
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