Healthcare Provider Details

I. General information

NPI: 1669688206
Provider Name (Legal Business Name): STEVE MINH HOANG BA SOCIOLOGY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 S WHITE RD STE 200
SAN JOSE CA
95148-2073
US

IV. Provider business mailing address

2670 S WHITE RD STE 200
SAN JOSE CA
95148-2073
US

V. Phone/Fax

Practice location:
  • Phone: 408-937-1553
  • Fax:
Mailing address:
  • Phone: 408-937-1553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number1669688206
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: