Basic Information
| Provider Information | |||||||||
| NPI: | 1316359110 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOANG | ||||||||
| FirstName: | BINH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1445 N OXFORD AVE | ||||||||
| Address2: | |||||||||
| City: | CLOVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936197609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596656100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 21633 AVENUE 24 | ||||||||
| Address2: | |||||||||
| City: | CHOWCHILLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936109650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596656100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2014 | ||||||||
| LastUpdateDate: | 05/28/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 46734 | CA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.