Provider Demographics
NPI:1508694613
Name:NGUYEN HOANG, DUC MINH (AA)
Entity type:Individual
Prefix:
First Name:DUC
Middle Name:MINH
Last Name:NGUYEN HOANG
Suffix:
Gender:M
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17732 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6809
Mailing Address - Country:US
Mailing Address - Phone:714-655-7142
Mailing Address - Fax:833-224-5825
Practice Address - Street 1:17732 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6809
Practice Address - Country:US
Practice Address - Phone:714-655-7142
Practice Address - Fax:833-224-5825
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician