Provider Demographics
NPI:1447723499
Name:LY, HOA HONG (PHARMD)
Entity type:Individual
Prefix:
First Name:HOA
Middle Name:HONG
Last Name:LY
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 1:5190 CORTE BOCINA APT 93
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5442
Mailing Address - Country:US
Mailing Address - Phone:714-471-8965
Mailing Address - Fax:
Practice Address - Street 1:6040 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-4372
Practice Address - Country:US
Practice Address - Phone:805-650-2155
Practice Address - Fax:805-650-2160
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist