Provider Demographics
NPI:1669741328
Name:DANG, CAROLYN H K (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:H K
Last Name:DANG
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 1:900 S HASTINGS AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-3426
Mailing Address - Country:US
Mailing Address - Phone:714-213-6284
Mailing Address - Fax:
Practice Address - Street 1:1538 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2231
Practice Address - Country:US
Practice Address - Phone:714-288-1790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist