Healthcare Provider Details

I. General information

NPI: 1770161002
Provider Name (Legal Business Name): JAMES HUY HOANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 960, TARAWA RD, CAMP FOSTER, GINOWAN-SHI, OKI
OKINAWA JAPAN
96362
JP

IV. Provider business mailing address

6301 MONROE PL
NORFOLK VA
23508-1266
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 310-848-9871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101276470
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: