Provider Demographics
NPI:1689924151
Name:NGUYEN, HOA MAI
Entity Type:Individual
Prefix:
First Name:HOA MAI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9122 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-3405
Mailing Address - Country:US
Mailing Address - Phone:714-378-0900
Mailing Address - Fax:
Practice Address - Street 1:9122 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646
Practice Address - Country:US
Practice Address - Phone:714-378-0900
Practice Address - Fax:714-378-5166
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281555207Q00000X
CAA145957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine