Provider Demographics
NPI:1629110879
Name:DOAN, HOA NGOC (DC)
Entity Type:Individual
Prefix:
First Name:HOA
Middle Name:NGOC
Last Name:DOAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W HOSPITALITY LN STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3317
Mailing Address - Country:US
Mailing Address - Phone:909-888-2210
Mailing Address - Fax:909-383-8081
Practice Address - Street 1:155 W HOSPITALITY LN STE 105
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3317
Practice Address - Country:US
Practice Address - Phone:909-888-2210
Practice Address - Fax:909-383-8081
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor