Healthcare Provider Details

I. General information

NPI: 1851424071
Provider Name (Legal Business Name): VANNA T HOANG O.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 S MAGNOLIA AVE
ANAHEIM CA
92804-5116
US

IV. Provider business mailing address

15332 SUMMERWOOD ST
WESTMINSTER CA
92683-6866
US

V. Phone/Fax

Practice location:
  • Phone: 714-757-4747
  • Fax: 714-948-5959
Mailing address:
  • Phone: 714-757-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11892T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: