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NPI Code Detail

MEDICARE: JANICE MAI NGOC HOANG PA-C

MEDICARE: JANICE MAI NGOC HOANG PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant15-02038KS

General Provider Information

NPI Number : 1598283707
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE MAI NGOC HOANG PA-C
Provider Business Mailing Address
First Line : 4813 E PEMBROOK CT
Second Line :
City : WICHITA
State : KS
Zip : 67220-2645
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2051 E MARY ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-3617
Country : US
Telephone Number : 620-765-1450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2017
Last Update Date : 09/18/2017

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Directions to “ JANICE MAI NGOC HOANG PA-C” Practice Location

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