Healthcare Provider Details

I. General information

NPI: 1316861024
Provider Name (Legal Business Name): THAOHOANG PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 S EUCLID ST
ANAHEIM CA
92802-1523
US

IV. Provider business mailing address

934 S EUCLID ST
ANAHEIM CA
92802-1523
US

V. Phone/Fax

Practice location:
  • Phone: 310-594-6704
  • Fax:
Mailing address:
  • Phone: 310-594-6704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: THAO YEN HOANG
Title or Position: OWNER
Credential: DO
Phone: 310-594-6704