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NPI Code Detail

MEDICARE: MRS. MARY CHUNG-NING DUONG PAC

MEDICARE:  MRS. MARY CHUNG-NING DUONG  PAC
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
1364SX0200XOncology Clinical Nurse SpecialistPA15424CA
2363A00000XPhysician AssistantPA15424CA

General Provider Information

NPI Number : 1386607638
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY CHUNG-NING DUONG PAC
Provider Business Mailing Address
First Line : PO BOX 31309
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-0309
Country : US
Telephone Number : 310-272-7640
Fax Number :
Provider Business Practice Location Address
First Line : 12414 EXPOSITION BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1016
Country : US
Telephone Number : 310-272-7640
Fax Number : 310-272-7656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 07/07/2021

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Directions to “ MRS. MARY CHUNG-NING DUONG PAC” Practice Location

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