Provider Demographics
NPI:1245729540
Name:HOANG, NINI (PHARMD)
Entity type:Individual
Prefix:
First Name:NINI
Middle Name:
Last Name:HOANG
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 1:3616 W AVENUE J10
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6313
Mailing Address - Country:US
Mailing Address - Phone:661-406-3388
Mailing Address - Fax:
Practice Address - Street 1:44665 VALLEY CENTRAL WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-6500
Practice Address - Country:US
Practice Address - Phone:661-940-8891
Practice Address - Fax:661-942-4272
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist