Healthcare Provider Details

I. General information

NPI: 1801583935
Provider Name (Legal Business Name): KIM-YEN DUONG BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 E BELLEVIEW AVE STE 500
ENGLEWOOD CO
80111-6077
US

IV. Provider business mailing address

7887 E BELLEVIEW AVE STE 500
ENGLEWOOD CO
80111-6077
US

V. Phone/Fax

Practice location:
  • Phone: 720-287-3093
  • Fax:
Mailing address:
  • Phone: 720-287-3093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: