Provider Demographics
NPI:1245789395
Name:HOGAN, ALEX HOANG NAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:HOANG NAM
Last Name:HOGAN
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 1:10161 BOLSA AVE STE 105B
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6770
Mailing Address - Country:US
Mailing Address - Phone:714-531-7000
Mailing Address - Fax:714-531-7047
Practice Address - Street 1:10161 BOLSA AVE STE 105B
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6770
Practice Address - Country:US
Practice Address - Phone:714-531-7000
Practice Address - Fax:714-531-7047
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist