MEDICARE: HONG YEN DANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	69772	CA

General Provider Information

NPI Number	:	1447673470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONG YEN DANG

Provider Business Mailing Address
First Line	:	2245 S EUCLID AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-6519
Country	:	US
Telephone Number	:	909-984-0140
Fax Number	:	909-984-0508

Provider Business Practice Location Address
First Line	:	2245 S EUCLID AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-6519
Country	:	US
Telephone Number	:	909-984-0140
Fax Number	:	909-984-0508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2014
Last Update Date	:	01/27/2014

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Directions to “ HONG YEN DANG ” Practice Location

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