Healthcare Provider Details

I. General information

NPI: 1164430773
Provider Name (Legal Business Name): THU-ANH HOANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1495
US

IV. Provider business mailing address

14445 OLIVE VIEW DR
SYLMAR CA
91342-1495
US

V. Phone/Fax

Practice location:
  • Phone: 818-364-6094
  • Fax: 818-364-4071
Mailing address:
  • Phone: 818-364-6094
  • Fax: 818-364-4071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA44972
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: