Provider Demographics
NPI:1467835009
Name:HENG, HOUN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HOUN
Middle Name:
Last Name:HENG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1488
Mailing Address - Country:US
Mailing Address - Phone:909-590-8373
Mailing Address - Fax:909-590-3656
Practice Address - Street 1:3255 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1488
Practice Address - Country:US
Practice Address - Phone:909-590-8373
Practice Address - Fax:909-590-3656
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist