Individual provider Active NPI

Mimi Ngoc Hoang, DO

  • Family Medicine Physician
  • Tustin, CA
National Provider Identifier
1891377594
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A22761 Issued in CA
Practice address
15000 Kensington Park Dr
Tustin, CA 92782-1830
Phone
(714) 477-8310
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A22761 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

15000 Kensington Park Dr
Tustin, CA 92782-1830

Mailing address

1645 Rivendel Dr
Corona, CA 92883-0717
Phone (951) 454-3525

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
I20240904003360 CA Practitioner - Family Practice 3072053123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

15000 Kensington Park Dr
Suite 250
Tustin, CA 92782-1835
Phone (714) 477-8320

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22761CAMDFamily Medicine Physician
22761CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Sep 16, 2024 Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

15000 Kensington Park Dr
Ste 250
Tustin, CA 92782
Phone (714) 477-8320

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1891377594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 RIVENDEL DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830717",
            "telephone_number": "951-454-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821830",
            "telephone_number": "714-477-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "MIMI",
        "middle_name": "NGOC",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22761",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.