Healthcare Provider Details

I. General information

NPI: 1033794953
Provider Name (Legal Business Name): DANIEL HOA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3943 E ANAHEIM ST
LONG BEACH CA
90804-4101
US

IV. Provider business mailing address

6003 SILVA ST
LAKEWOOD CA
90713-1927
US

V. Phone/Fax

Practice location:
  • Phone: 562-597-4500
  • Fax:
Mailing address:
  • Phone: 714-322-3293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS105918
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: