Provider Demographics
NPI:1932611183
Name:HOANG, VAN ANH QUYNH
Entity Type:Individual
Prefix:
First Name:VAN ANH
Middle Name:QUYNH
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 1:600 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-1321
Mailing Address - Country:US
Mailing Address - Phone:562-279-1027
Mailing Address - Fax:562-279-1022
Practice Address - Street 1:600 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-1321
Practice Address - Country:US
Practice Address - Phone:562-279-1027
Practice Address - Fax:562-279-1022
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist