Individual ProviderHenry HoangNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address757 Westwood Plz, Los Angeles, CA 90095(310) 267-8800PECOS EnrollmentBased on the most recent information from CMS, provider Henry Hoang is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1063741205Provider TypeIndividualFull NameHoang, HenryTitleMr.CredentialACNP-BCGenderMaleSole ProprietorNoEnumeration Date12/17/2009Last Updated2/14/2022Contact InformationPractice LocationPractice Address757 Westwood Plz, Los Angeles, CA 90095Phone(310) 267-8800FaxUnlisted FaxMailing LocationMailing Address5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LA2100XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95000338CaliforniaCode363LA2100XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR188868Maryland