Provider Demographics
NPI:1669060935
Name:KENNETH Q HOANG DC A CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:KENNETH Q HOANG DC A CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-448-8599
Mailing Address - Street 1:24541 PACIFIC PARK DR STE 290
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3058
Mailing Address - Country:US
Mailing Address - Phone:949-448-8599
Mailing Address - Fax:949-448-8595
Practice Address - Street 1:24541 PACIFIC PARK DR STE 290
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3058
Practice Address - Country:US
Practice Address - Phone:949-448-8599
Practice Address - Fax:949-448-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty