Basic Information
| Provider Information | |||||||||
| NPI: | 1316565799 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOANG | ||||||||
| FirstName: | CELIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 651 FRANKLIN ST APT 4202 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940411959 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142618868 | ||||||||
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| Practice Location | |||||||||
| Address1: | 250 HOSPITAL PKWY | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089723000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2020 | ||||||||
| LastUpdateDate: | 07/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 41615 | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 183500000X | 84485 | CA | Y | Pharmacy Service Providers | Pharmacist |
ID Information
| ID | Type | State | Issuer | Description | 84485 | 01 | CA | CA STATE BOARD | OTHER |