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NPI Code Detail

MEDICARE: DR. HOANGTIEN H LA D.O.

MEDICARE: DR. HOANGTIEN H LA D.O.
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
1207L00000XAnesthesiology Physician20A8145CA
2207L00000XAnesthesiology Physician006202AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942261912
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOANGTIEN H LA D.O.
Provider Business Mailing Address
First Line : PO BOX 13385
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85267-3385
Country : US
Telephone Number : 480-609-9300
Fax Number : 480-609-9350
Provider Business Practice Location Address
First Line : 250 E DUNLAP AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-2825
Country : US
Telephone Number : 602-273-9333
Fax Number : 480-609-9350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2006
Last Update Date : 10/13/2014

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Directions to “ DR. HOANGTIEN H LA D.O.” Practice Location

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