Healthcare Provider Details

I. General information

NPI: 1770722696
Provider Name (Legal Business Name): VIET HOANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W DUARTE RD STE 301
ARCADIA CA
91007-9277
US

IV. Provider business mailing address

622 W DUARTE RD STE 301
ARCADIA CA
91007-9277
US

V. Phone/Fax

Practice location:
  • Phone: 714-251-0535
  • Fax:
Mailing address:
  • Phone: 714-251-0535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA87487
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: