Provider Demographics
NPI:1881914323
Name:HOANG, HUONG LAN (RPH)
Entity type:Individual
Prefix:
First Name:HUONG
Middle Name:LAN
Last Name:HOANG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2213
Mailing Address - Country:US
Mailing Address - Phone:714-828-1701
Mailing Address - Fax:
Practice Address - Street 1:9940 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6721
Practice Address - Country:US
Practice Address - Phone:909-822-8122
Practice Address - Fax:909-822-5855
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44889183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist