Provider Demographics
NPI:1922141464
Name:HOANG, MICHAEL D (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:HOANG
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17112 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2608
Mailing Address - Country:US
Mailing Address - Phone:310-515-5144
Mailing Address - Fax:
Practice Address - Street 1:901 E. ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-2608
Practice Address - Country:US
Practice Address - Phone:310-763-3479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer