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General NPI Number Information
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NPI Number | 1558771808
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Entity Type | Organization
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Legal Business Name | VANNA HOANG OD INC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1232 S MAGNOLIA AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-5116
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Country | US
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Telephone | 714-757-4747
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Fax | 714-948-5959
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Provider Business Mailing Address
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Address Line | 1232 S MAGNOLIA AVE
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City | ANAHEIM
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State | CA
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Zip | 92804-5116
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Country | US
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Telephone | 714-757-4747
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Fax | 714-636-2465
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Authorized Official
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Title or Position | CEO
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Name | VANNA T HOANG
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Credential | OPTOMETRIST
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Telephone | 714-757-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11892T
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License Number State | CA
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