Provider Demographics
NPI:1215308010
Name:LE, HOANGNHAN HO (OD)
Entity type:Individual
Prefix:DR
First Name:HOANGNHAN
Middle Name:HO
Last Name:LE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S AMBOY ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-1209
Mailing Address - Country:US
Mailing Address - Phone:714-553-7696
Mailing Address - Fax:
Practice Address - Street 1:5811 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2021
Practice Address - Country:US
Practice Address - Phone:714-521-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004936152W00000X
CA34225152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist