Healthcare Provider Details
I. General information
NPI: 1730391020
Provider Name (Legal Business Name): MICHELLE HOANGQUOCGIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/07/2007
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US
IV. Provider business mailing address
PO BOX 7096
STOCKTON CA
95267-0096
US
V. Phone/Fax
- Phone: 310-423-5841
- Fax:
- Phone: 209-956-7725
- Fax: 209-956-7733
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 20A13341 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: