Provider Demographics
NPI:1932676582
Name:HOANG, VIET ANH (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:VIET
Middle Name:ANH
Last Name:HOANG
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-3822
Mailing Address - Country:US
Mailing Address - Phone:858-349-1789
Mailing Address - Fax:
Practice Address - Street 1:1520 4TH ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-3822
Practice Address - Country:US
Practice Address - Phone:858-349-1789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0016959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist