Provider Demographics
NPI:1083971618
Name:HOANG, VANESSA KIMIKO MARTIN (DO, MS)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:KIMIKO MARTIN
Last Name:HOANG
Suffix:
Gender:F
Credentials:DO, MS
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Mailing Address - Street 1:25632 HORSE SHOE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4313
Mailing Address - Country:US
Mailing Address - Phone:949-291-4468
Mailing Address - Fax:
Practice Address - Street 1:3000 SILLECT AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6336
Practice Address - Country:US
Practice Address - Phone:661-336-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-20
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A13188207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology