Individual provider Active NPI

Brian C Hoang, PA

  • Occupational Medicine Physician
  • San Diego, CA
National Provider Identifier
1073239646
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
PA62179 Issued in CA
Practice address
4510 Executive Dr Ste 107
San Diego, CA 92121-3022
Phone
(858) 457-4717
NPI assigned
Oct 17, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X PA62179 CA Primary

Addresses

Primary practice location

4510 Executive Dr Ste 107
San Diego, CA 92121-3022

Mailing address

15311 Vermont St
Westminster, CA 92683-6155
Phone (714) 718-2647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA62179CAMDOccupational Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1073239646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15311 VERMONT ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926836155",
            "telephone_number": "714-718-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 EXECUTIVE DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921213022",
            "telephone_number": "858-457-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "BRIAN",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-17",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "PA62179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.