Provider Demographics
NPI:1124567235
Name:TO, HOANG
Entity Type:Individual
Prefix:MR
First Name:HOANG
Middle Name:
Last Name:TO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8267 DALKEITH WAY
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-5120
Mailing Address - Country:US
Mailing Address - Phone:714-468-9769
Mailing Address - Fax:
Practice Address - Street 1:8267 DALKEITH WAY
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-5120
Practice Address - Country:US
Practice Address - Phone:714-468-9769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator