MEDICARE: CONNIE HOA LY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	20A25536	CA

General Provider Information

NPI Number	:	1346942307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE HOA LY DO

Provider Business Mailing Address
First Line	:	1200 N STATE ST
Second Line	:	CLINIC TOWER ROOM A7D
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-1029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N. STATE ST
Second Line	:	CLINIC TOWER, SUITE A7D
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-9003
Country	:	US
Telephone Number	:	323-409-6931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	06/18/2026

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Directions to “ CONNIE HOA LY DO” Practice Location

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