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General NPI Number Information
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NPI Number | 1710034848
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Entity Type | Organization
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Legal Business Name | TUE NGOC HOANG
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 9972 BOLSA AVE STE 103
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City | WESTMINSTER
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State | CA
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Zip | 92683-6069
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Country | US
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Telephone | 714-775-6301
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Fax | 714-775-0891
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Provider Business Mailing Address
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Address Line | 9972 BOLSA AVE STE 103
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City | WESTMINSTER
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State | CA
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Zip | 92683-6069
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Country | US
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Telephone | 714-775-6301
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Fax | 714-775-0891
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Authorized Official
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Title or Position | GENERAL MGR
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Name | MR. P HOANG
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Credential |
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Telephone | 714-775-6301
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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 | PHY35565
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License Number State | CA
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