Healthcare Provider Details

I. General information

NPI: 1487957270
Provider Name (Legal Business Name): HOANG KIM DO MD PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 SARATOGA AVE SUITE 4A
SARATOGA CA
95070-6612
US

IV. Provider business mailing address

900 CAMERON CIR
MILPITAS CA
95035-7718
US

V. Phone/Fax

Practice location:
  • Phone: 408-866-9991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA82778
License Number StateCA

VIII. Authorized Official

Name: HOANG DO
Title or Position: CEO/PLASTIC SURGEON
Credential: M.D.
Phone: 408-866-9991