Healthcare Provider Details

I. General information

NPI: 1073724217
Provider Name (Legal Business Name): DUKE TRINH KHUU MD FAAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 CASTRO ST
MOUNTAIN VIEW CA
94041-2014
US

IV. Provider business mailing address

889 CASTRO ST
MOUNTAIN VIEW CA
94041-2014
US

V. Phone/Fax

Practice location:
  • Phone: 650-969-5488
  • Fax: 650-969-7546
Mailing address:
  • Phone: 650-969-5488
  • Fax: 650-969-7546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA100004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: