Provider Demographics
NPI:1164711578
Name:HOANG, ANDREW NHAT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NHAT
Last Name:HOANG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24511 W JAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-9503
Mailing Address - Country:US
Mailing Address - Phone:559-934-8009
Mailing Address - Fax:
Practice Address - Street 1:24511 WEST JAYNE AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-2302
Practice Address - Country:US
Practice Address - Phone:559-934-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 63566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist