Healthcare Provider Details

I. General information

NPI: 1093455016
Provider Name (Legal Business Name): LONG HAI HOANG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21810 NORMANDIE AVE FL 1
TORRANCE CA
90502-2047
US

IV. Provider business mailing address

21810 NORMANDIE AVE FL 1
TORRANCE CA
90502-2047
US

V. Phone/Fax

Practice location:
  • Phone: 424-492-3300
  • Fax:
Mailing address:
  • Phone: 424-492-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number20A21621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: