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NPI Code Detail

MEDICARE: VYVY HOANG

MEDICARE: VYVY HOANG
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
1106S00000XBehavior TechnicianRBT-19-76888CA
2363A00000XPhysician AssistantPA66571CA

General Provider Information

NPI Number : 1730644030
Entity Type Code : Individual
Provider Name (Legal Business Name) : VYVY HOANG
Provider Business Mailing Address
First Line : 910 CAMPISI WAY STE 2A
Second Line :
City : CAMPBELL
State : CA
Zip : 95008-2351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 ACACIA AVE
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-2230
Country : US
Telephone Number : 415-457-4440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2019
Last Update Date : 11/10/2025

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Directions to “ VYVY HOANG ” Practice Location

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