Individual
DR. PHAT DAI HOANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13065 W MCDOWELL RD, SUITE A105, AVONDALE, AZ 85392-6439
(623) 536-6788
(623) 536-9288
Mailing address
P.O. BOX 7310, PHOENIX, AZ 85011-7310
(623) 536-6788
(623) 536-9288
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23025
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332049
—
AZ
01
—
Z109444
MEDICARE LEGACY NUMBER
AZ
Enumeration date
08/16/2005
Last updated
02/10/2011
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