Provider Demographics
NPI:1902350044
Name:HO, VAN HOAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VAN
Middle Name:HOAN
Last Name:HO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 E APACHE BLVD
Mailing Address - Street 2:APT 3078
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6088
Mailing Address - Country:US
Mailing Address - Phone:858-380-9641
Mailing Address - Fax:
Practice Address - Street 1:1811 E APACHE BLVD
Practice Address - Street 2:APT 3078
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6088
Practice Address - Country:US
Practice Address - Phone:858-380-9641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022016183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist