Healthcare Provider Details

I. General information

NPI: 1972844561
Provider Name (Legal Business Name): DAT N DUONG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALTON PKWY STE 101
IRVINE CA
92606-5032
US

IV. Provider business mailing address

PO BOX 1436
GARDEN GROVE CA
92842-1436
US

V. Phone/Fax

Practice location:
  • Phone: 949-222-2722
  • Fax: 949-222-9969
Mailing address:
  • Phone: 586-604-2929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number16433
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number16433
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number16433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: