Healthcare Provider Details

I. General information

NPI: 1841679818
Provider Name (Legal Business Name): KATHY HOANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2015
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 STANTON L YOUNG BLVD
OKLAHOMA CITY OK
73104-5036
US

IV. Provider business mailing address

1650 NW NAITO PKWY STE 185
PORTLAND OR
97209-2535
US

V. Phone/Fax

Practice location:
  • Phone: 405-979-0329
  • Fax:
Mailing address:
  • Phone: 971-983-5260
  • Fax: 503-525-7652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD200217
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD200217
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: