Healthcare Provider Details

I. General information

NPI: 1689770018
Provider Name (Legal Business Name): THU-THUY THI DANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2146 E ANAHEIM ST
LONG BEACH CA
90804-3408
US

IV. Provider business mailing address

15621 BURNING TREE ST
WESTMINSTER CA
92683-6825
US

V. Phone/Fax

Practice location:
  • Phone: 562-439-7227
  • Fax: 562-438-4737
Mailing address:
  • Phone: 714-379-5156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA739910
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: