Provider Demographics
NPI:1215263348
Name:HENG, MALY (RPH)
Entity type:Individual
Prefix:MS
First Name:MALY
Middle Name:
Last Name:HENG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 FLORIN RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-1804
Mailing Address - Country:US
Mailing Address - Phone:916-421-6486
Mailing Address - Fax:916-421-3136
Practice Address - Street 1:4020 FLORIN RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-1804
Practice Address - Country:US
Practice Address - Phone:916-421-6486
Practice Address - Fax:916-421-3136
Is Sole Proprietor?:No
Enumeration Date:2009-10-24
Last Update Date:2009-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 50689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV14526OtherRPH LICENSE
CA50689OtherRPH LICENSE