Provider Demographics
NPI:1245372846
Name:HOANG, HUY QUANG (MD)
Entity type:Individual
Prefix:DR
First Name:HUY
Middle Name:QUANG
Last Name:HOANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4469 REDONDO BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3465
Mailing Address - Country:US
Mailing Address - Phone:310-479-2266
Mailing Address - Fax:310-479-2044
Practice Address - Street 1:4469 REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-3465
Practice Address - Country:US
Practice Address - Phone:310-479-2266
Practice Address - Fax:310-479-2044
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG67666DMedicare ID - Type Unspecified
CAE83597Medicare UPIN