Provider Demographics
NPI:1225009178
Name:HOANG, THANH DUC (DO)
Entity Type:Individual
Prefix:DR
First Name:THANH
Middle Name:DUC
Last Name:HOANG
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:NAVAL MEDICAL CTR
Mailing Address - Street 2:34800 BOB WILSON DRIVE, BLDG 3, 2ND FLOOR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-0001
Mailing Address - Country:US
Mailing Address - Phone:619-532-7375
Mailing Address - Fax:619-532-5472
Practice Address - Street 1:NAVAL MEDICAL CTR
Practice Address - Street 2:34800 BOB WILSON DRIVE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-0001
Practice Address - Country:US
Practice Address - Phone:619-532-7375
Practice Address - Fax:619-532-5472
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2014-02-14
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Provider Licenses
StateLicense IDTaxonomies
VA0102201771207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN