Healthcare Provider Details
I. General information
NPI: 1619626595
Provider Name (Legal Business Name): RACHEL TU-UYEN DUONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/19/2022
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9333 GENESEE AVE STE 200
SAN DIEGO CA
92121-2113
US
IV. Provider business mailing address
FILE 57326
LOS ANGELES CA
90074-7326
US
V. Phone/Fax
- Phone: 800-926-8273
- Fax: 888-539-8781
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | A190605 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | A190605 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: