Provider Demographics
NPI:1477908929
Name:NGO, HAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:
Last Name:NGO
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 1:2151 N HARBOR BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3825
Mailing Address - Country:US
Mailing Address - Phone:714-446-7149
Mailing Address - Fax:
Practice Address - Street 1:2151 N HARBOR BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3825
Practice Address - Country:US
Practice Address - Phone:714-446-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61620183500000X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No183500000XPharmacy Service ProvidersPharmacist