Healthcare Provider Details

I. General information

NPI: 1114080694
Provider Name (Legal Business Name): ROBERT ANH HOANG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 W WHITTIER BLVD
MONTEBELLO CA
90640-4735
US

IV. Provider business mailing address

4215 RIO HONDO AVE
ROSEMEAD CA
91770-1525
US

V. Phone/Fax

Practice location:
  • Phone: 323-266-1000
  • Fax: 323-890-2955
Mailing address:
  • Phone: 626-975-1993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: