Provider Demographics
NPI:1013427392
Name:HOANG, BRIAN VIET
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:VIET
Last Name:HOANG
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:VIET
Other - Last Name:HOANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8470 ELK GROVE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5925
Mailing Address - Country:US
Mailing Address - Phone:916-667-3852
Mailing Address - Fax:916-896-5194
Practice Address - Street 1:8470 ELK GROVE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5925
Practice Address - Country:US
Practice Address - Phone:916-667-3852
Practice Address - Fax:916-896-5194
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist