Provider Demographics
NPI:1629547849
Name:PREMIER WOMENS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:PREMIER WOMENS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-829-7500
Mailing Address - Street 1:8305 BRIMHALL RD STE 1602
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2172
Mailing Address - Country:US
Mailing Address - Phone:661-829-7500
Mailing Address - Fax:661-829-7470
Practice Address - Street 1:8305 BRIMHALL ROAD
Practice Address - Street 2:SUITE #1602
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2172
Practice Address - Country:US
Practice Address - Phone:661-829-7500
Practice Address - Fax:661-829-7470
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER WOMENS MEDICAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-16
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty