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NPI Code Detail

MEDICARE: KIM DUONG

MEDICARE: KIM DUONG
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1689420754
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM DUONG
Provider Business Mailing Address
First Line : 751 S BASCOM AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2699
Country : US
Telephone Number : 408-885-5000
Fax Number :
Provider Business Practice Location Address
First Line : 751 S BASCOM AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2699
Country : US
Telephone Number : 408-885-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2024
Last Update Date : 06/08/2026

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Directions to “ KIM DUONG ” Practice Location

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