Provider Demographics
NPI:1770851669
Name:TRUONG, HAI BACH HOAI (PHARM D)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:BACH HOAI
Last Name:TRUONG
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 1:10356 BECKLEY WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3513
Mailing Address - Country:US
Mailing Address - Phone:916-402-0805
Mailing Address - Fax:
Practice Address - Street 1:3601 N FREEWAY BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-2902
Practice Address - Country:US
Practice Address - Phone:916-576-0487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist