Healthcare Provider Details

I. General information

NPI: 1235534678
Provider Name (Legal Business Name): KYLAA DUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W METROPOLITAN DR STE 120
ORANGE CA
92868-3504
US

IV. Provider business mailing address

4000 W METROPOLITAN DR
ORANGE CA
92868-3504
US

V. Phone/Fax

Practice location:
  • Phone: 714-972-3700
  • Fax: 714-972-3744
Mailing address:
  • Phone: 714-972-3700
  • Fax: 714-972-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: