Provider Demographics
NPI:1760728984
Name:HUA, HA THANH (PHARMD)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:THANH
Last Name:HUA
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 1:295 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3691
Mailing Address - Country:US
Mailing Address - Phone:530-662-1795
Mailing Address - Fax:530-662-6261
Practice Address - Street 1:295 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3691
Practice Address - Country:US
Practice Address - Phone:530-662-1795
Practice Address - Fax:530-662-6261
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist