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	207R00000X	Internal Medicine Physician	A122050	CA
2	207RC0000X	Cardiovascular Disease Physician	A122050	CA
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	A122050	CA

General Provider Information

NPI Number	:	1881985521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUC H DO M.D.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:	310-301-8771
Fax Number	:	310-301-8751

Provider Business Practice Location Address
First Line	:	100 UCLA MEDICAL PLAZA SUITE 660
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-1448
Country	:	US
Telephone Number	:	909-263-3655
Fax Number	:

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

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	10/05/2020

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