Provider Demographics
NPI:1710541784
Name:DANG, LINH M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:M
Last Name:DANG
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18682 BEACH BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2049
Mailing Address - Country:US
Mailing Address - Phone:714-964-4004
Mailing Address - Fax:714-964-4166
Practice Address - Street 1:18682 BEACH BLVD STE 115
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2049
Practice Address - Country:US
Practice Address - Phone:714-964-4004
Practice Address - Fax:714-964-4166
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist