Provider Demographics
NPI:1518736057
Name:HOANG, HUY QUOC (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HUY
Middle Name:QUOC
Last Name:HOANG
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 1:15231 EDEN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5472
Mailing Address - Country:US
Mailing Address - Phone:714-837-5846
Mailing Address - Fax:714-664-0680
Practice Address - Street 1:12540 MCCANN DR
Practice Address - Street 2:
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3337
Practice Address - Country:US
Practice Address - Phone:714-664-0518
Practice Address - Fax:714-664-0680
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist