Provider Demographics
NPI:1497235725
Name:HO, CUONG QUOC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CUONG
Middle Name:QUOC
Last Name:HO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 BOLSA AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5944
Mailing Address - Country:US
Mailing Address - Phone:714-884-4742
Mailing Address - Fax:
Practice Address - Street 1:9550 BOLSA AVE STE 109
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5944
Practice Address - Country:US
Practice Address - Phone:714-884-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54638183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist