Provider Demographics
NPI:1396356259
Name:HOANG, HAILEY ANH
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:ANH
Last Name:HOANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7761 GARDEN GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4200
Mailing Address - Country:US
Mailing Address - Phone:714-248-9663
Mailing Address - Fax:
Practice Address - Street 1:7761 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4200
Practice Address - Country:US
Practice Address - Phone:714-248-9663
Practice Address - Fax:714-248-9683
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist