Healthcare Provider Details

I. General information

NPI: 1871425777
Provider Name (Legal Business Name): JOHN HOANG PHYSICIAN ASSISTANT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3767 ELIZABETH ST
RIVERSIDE CA
92506-2508
US

IV. Provider business mailing address

14615 MAGNOLIA ST
WESTMINSTER CA
92683-5544
US

V. Phone/Fax

Practice location:
  • Phone: 951-858-6668
  • Fax:
Mailing address:
  • Phone: 951-858-6668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN LONG HOANG
Title or Position: CEO
Credential: PA
Phone: 714-267-8087