Provider Demographics
NPI:1093534539
Name:HOANG, MICHAEL QUY (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:QUY
Last Name:HOANG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10521 STONY RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-6139
Mailing Address - Country:US
Mailing Address - Phone:858-610-8982
Mailing Address - Fax:
Practice Address - Street 1:6264 FERRIS SQ
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3204
Practice Address - Country:US
Practice Address - Phone:619-940-4128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist