Provider Demographics
NPI:1205482999
Name:HOANG, NGUYET HOANH
Entity type:Individual
Prefix:
First Name:NGUYET
Middle Name:HOANH
Last Name:HOANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1250
Mailing Address - Country:US
Mailing Address - Phone:530-345-1363
Mailing Address - Fax:
Practice Address - Street 1:801 EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1250
Practice Address - Country:US
Practice Address - Phone:530-345-1363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist