Healthcare Provider Details

I. General information

NPI: 1922392679
Provider Name (Legal Business Name): STANLEY HOANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2011
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N TUSTIN AVE STE 400
SANTA ANA CA
92705-3850
US

IV. Provider business mailing address

400 N TUSTIN AVE STE 400
SANTA ANA CA
92705-3850
US

V. Phone/Fax

Practice location:
  • Phone: 714-619-5383
  • Fax:
Mailing address:
  • Phone: 714-619-5383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number16004
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC179364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: