Healthcare Provider Details

I. General information

NPI: 1891146205
Provider Name (Legal Business Name): HBCA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15039 GOLDENWEST ST
HUNTINGTON BEACH CA
92647-2710
US

IV. Provider business mailing address

15039 GOLDENWEST ST
HUNTINGTON BEACH CA
92647-2710
US

V. Phone/Fax

Practice location:
  • Phone: 714-895-8808
  • Fax:
Mailing address:
  • Phone: 714-895-8808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MISS MINHHANG NGUYEN
Title or Position: SECRETARY
Credential:
Phone: 714-863-9559