Provider Demographics
NPI:1538483425
Name:HA, KHOI VINH (PHARM D)
Entity Type:Individual
Prefix:
First Name:KHOI
Middle Name:VINH
Last Name:HA
Suffix:
Gender:M
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 1:3491 BAGNOLI CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3469
Mailing Address - Country:US
Mailing Address - Phone:714-326-4323
Mailing Address - Fax:
Practice Address - Street 1:6865 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3017
Practice Address - Country:US
Practice Address - Phone:805-968-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist