Healthcare Provider Details

I. General information

NPI: 1801709613
Provider Name (Legal Business Name): LAN THI MINH DANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANA DANG

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 LIMONITE AVE STE 101
JURUPA VALLEY CA
92509-5342
US

IV. Provider business mailing address

14921 OAKBURY DR 14921 OAKBURY DR
LA MIRADA CA
90638-4532
US

V. Phone/Fax

Practice location:
  • Phone: 951-380-8201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95041633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: