Healthcare Provider Details

I. General information

NPI: 1295815736
Provider Name (Legal Business Name): QUYNH THI NGOC VO-HANSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: QUYNH VO MD

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23441 MADISON STREET BLDG 8, SUITE 290
TORRANCE CA
90505-4735
US

IV. Provider business mailing address

770 THE CITY DRIVE SOUTH SUITE 4000
ORANGE CA
92868-4929
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-7172
  • Fax: 310-375-7192
Mailing address:
  • Phone: 800-463-6628
  • Fax: 714-620-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number12533
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number130507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: