Individual provider Active NPI

Michael Hung Vo, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1790712164
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G79118 Issued in CA
Practice address
1025 W Olympic Blvd
Los Angeles, CA 90015-1329
Phone
(310) 354-4304
NPI assigned
Jun 28, 2006
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G79118 CA Primary

Addresses

Primary practice location

1025 W Olympic Blvd
Los Angeles, CA 90015-1329

Mailing address

15405 Calle Rosa Rd
Moreno Valley, CA 92555-2959
Phone (408) 219-7514

Other identifiers 1

IdentifierTypeStateIssuer
G791180MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000472 CA Practitioner - Diagnostic Radiology 4082621602 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G79118CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
UC Regents Diagnostic Radiology CurrentSince Feb 19, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 3, 2011 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 15, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 15, 2024 Accepting new patients
UC Regents Diagnostic Radiology CurrentSince Feb 19, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 3, 2011 Accepting new patients
University of California Irvine Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225

2601 Via Campo
Montebello, CA 90640
Phone (323) 720-1144

2603 Via Campo
Montebello, CA 90640
Phone (323) 720-1144

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

29409 S Western Ave
Rancho Palos Verdes, CA 90275
Phone (310) 784-6848

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1790712164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15405 CALLE ROSA RD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925552959",
            "telephone_number": "408-219-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W OLYMPIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151329",
            "telephone_number": "310-354-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VO",
        "first_name": "MICHAEL",
        "middle_name": "HUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G79118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G791180",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.