Healthcare Provider Details

I. General information

NPI: 1629235825
Provider Name (Legal Business Name): VINH Q DANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S MANCHESTER AVE STE #110
ORANGE CA
92868-3217
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE #110
ORANGE CA
92868-3217
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-2332
  • Fax:
Mailing address:
  • Phone: 714-456-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA90287
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA92087
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberA90287
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: