Provider Demographics
NPI:1437533411
Name:HOANG, TIFFANY T (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:T
Last Name:HOANG
Suffix:
Gender:F
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:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92684-0094
Mailing Address - Country:US
Mailing Address - Phone:714-489-1728
Mailing Address - Fax:
Practice Address - Street 1:2055 N PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-2509
Practice Address - Country:US
Practice Address - Phone:951-943-8188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist