Healthcare Provider Details

I. General information

NPI: 1649575135
Provider Name (Legal Business Name): VY HOANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E CHASE AVE
EL CAJON CA
92020-6305
US

IV. Provider business mailing address

7220 MARGERUM AVE
SAN DIEGO CA
92120-2012
US

V. Phone/Fax

Practice location:
  • Phone: 619-442-2560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA125768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: