=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922364009
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DUONG VIEN HO-HOANG D.O., M.ED.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2012
-----------------------------------------------------
Last Update Date | 12/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | KAISER PERMANENTE 9449 E. IMPERIAL HWY
-----------------------------------------------------
City | DOWNEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-807-6200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9449 IMPERIAL HWY
-----------------------------------------------------
City | DOWNEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90242-2814
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-807-6200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | 20A13202
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------