Provider Demographics
NPI:1669193587
Name:MK HOANG OD INC
Entity type:Organization
Organization Name:MK HOANG OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-209-1255
Mailing Address - Street 1:1102 IRVINE BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3529
Mailing Address - Country:US
Mailing Address - Phone:714-838-3210
Mailing Address - Fax:714-838-5702
Practice Address - Street 1:1102 IRVINE BLVD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3529
Practice Address - Country:US
Practice Address - Phone:714-838-3210
Practice Address - Fax:714-838-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty