MEDICARE: DR. DUC H. DO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A70134	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WA70134C	OTHER	CA	PPIN

General Provider Information

NPI Number	:	1336136951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUC H. DO M.D.

Provider Business Mailing Address
First Line	:	520 SUPERIOR AVE
Second Line	:	STE 200
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3642
Country	:	US
Telephone Number	:	949-574-4114
Fax Number	:	949-574-4144

Provider Business Practice Location Address
First Line	:	355 PLACENTIA AVE STE 207A
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3302
Country	:	US
Telephone Number	:	949-574-4114
Fax Number	:	949-574-4144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	08/06/2019

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