Provider Demographics
NPI:1619493129
Name:LUONG, ANGIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:LUONG
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 1:16133 VENTURA BLVD
Mailing Address - Street 2:470
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2403
Mailing Address - Country:US
Mailing Address - Phone:818-981-3818
Mailing Address - Fax:818-784-3106
Practice Address - Street 1:16133 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2403
Practice Address - Country:US
Practice Address - Phone:818-981-3818
Practice Address - Fax:818-784-3106
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA748211835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Single Specialty