Provider Demographics
NPI:1598478273
Name:HONG, MONICA VAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:VAN
Last Name:HONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 BIG DALTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746-1917
Mailing Address - Country:US
Mailing Address - Phone:626-485-8570
Mailing Address - Fax:
Practice Address - Street 1:740 BIG DALTON AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-1917
Practice Address - Country:US
Practice Address - Phone:626-485-8570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP9594183500000X
NV21123183500000X
CA87383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist