Healthcare Provider Details

I. General information

NPI: 1588696223
Provider Name (Legal Business Name): TU HOANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 COMMERCENTER E SUITE 120
SAN BERNARDINO CA
92408-3456
US

IV. Provider business mailing address

17118 FIRST LIGHT LN
RIVERSIDE CA
92503-8708
US

V. Phone/Fax

Practice location:
  • Phone: 909-388-9222
  • Fax:
Mailing address:
  • Phone: 909-883-2394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA79962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: