Healthcare Provider Details

I. General information

NPI: 1255033270
Provider Name (Legal Business Name): NGOC H DUONG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 MANHATTAN BEACH BLVD STE 102
MANHATTAN BEACH CA
90266-4965
US

IV. Provider business mailing address

855 MANHATTAN BEACH BLVD STE 102
MANHATTAN BEACH CA
90266-4965
US

V. Phone/Fax

Practice location:
  • Phone: 310-939-7858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A23995
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: