Provider Demographics
NPI:1154916385
Name:DI, NGOC AMY HONG (PHARMD)
Entity type:Individual
Prefix:
First Name:NGOC AMY
Middle Name:HONG
Last Name:DI
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 1:12526 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2166
Mailing Address - Country:US
Mailing Address - Phone:714-554-1111
Mailing Address - Fax:714-554-7777
Practice Address - Street 1:12526 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2166
Practice Address - Country:US
Practice Address - Phone:714-554-1111
Practice Address - Fax:714-554-7777
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist