Healthcare Provider Details

I. General information

NPI: 1891817235
Provider Name (Legal Business Name): TONY LUAN HOANG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21615 HESPERIAN BLVD STE C
HAYWARD CA
94541-7026
US

IV. Provider business mailing address

PO BOX 610430
SAN JOSE CA
95161-0430
US

V. Phone/Fax

Practice location:
  • Phone: 510-586-0010
  • Fax:
Mailing address:
  • Phone: 408-768-2726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-29793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: