MEDICARE: TANYA THUY DUONG PHARMD

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	208U00000X	Clinical Pharmacology Physician	RPH47619	CA

General Provider Information

NPI Number	:	1346292117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA THUY DUONG PHARMD

Provider Business Mailing Address
First Line	:	5313 HIRSCH CIR
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95757-4321
Country	:	US
Telephone Number	:	916-230-7060
Fax Number	:	916-874-3620

Provider Business Practice Location Address
First Line	:	4600 BROADWAY
Second Line	:	SUITE 2200
City	:	SACRAMENTO
State	:	CA
Zip	:	95820-1527
Country	:	US
Telephone Number	:	916-874-3621
Fax Number	:	916-874-3620

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/08/2007

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