Provider Demographics
NPI:1477780252
Name:DANG, HANH THI (PHARM D)
Entity Type:Individual
Prefix:
First Name:HANH
Middle Name:THI
Last Name:DANG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14222 PINTAIL LOOP
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-0929
Mailing Address - Country:US
Mailing Address - Phone:760-887-7070
Mailing Address - Fax:
Practice Address - Street 1:17441 MAIN ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6268
Practice Address - Country:US
Practice Address - Phone:760-948-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH57286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist