MEDICARE: THUY DIEU ROTUNDA MD

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	2084P0800X	Psychiatry Physician	A86096	CA

General Provider Information

NPI Number	:	1457494957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUY DIEU ROTUNDA MD

Provider Business Mailing Address
First Line	:	1100 QUAIL ST STE 100A
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2702
Country	:	US
Telephone Number	:	949-608-9659
Fax Number	:	949-608-9659

Provider Business Practice Location Address
First Line	:	1100 QUAIL ST STE 100A
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2702
Country	:	US
Telephone Number	:	949-608-9659
Fax Number	:	949-608-9659

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/09/2025

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