Provider Demographics
NPI:1760667687
Name:DANG, HOANG T (PA-C)
Entity Type:Individual
Prefix:MR
First Name:HOANG
Middle Name:T
Last Name:DANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 CIVIC CENTER DR STE 7
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-7301
Mailing Address - Country:US
Mailing Address - Phone:408-985-2401
Mailing Address - Fax:
Practice Address - Street 1:1825 CIVIC CENTER DR STE 7
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-7301
Practice Address - Country:US
Practice Address - Phone:408-985-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 15848363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical