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General NPI Number Information
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NPI Number | 1619533759
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Entity Type | Individual
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Provider Name | DR. VAN ANH NGOC DOAN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 101 N CHINA LAKE BLVD
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City | RIDGECREST
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State | CA
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Zip | 93555-3915
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Country | US
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Telephone | 760-375-0223
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Fax |
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Provider Business Mailing Address
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Address Line | 5355 ELLEN ST
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City | RIVERSIDE
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State | CA
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Zip | 92503-2450
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH80107
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License Number State | CA
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