Healthcare Provider Details

I. General information

NPI: 1801590161
Provider Name (Legal Business Name): QUYNH VAN DUONG DO, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 W MOANA LN
RENO NV
89509-4991
US

IV. Provider business mailing address

1155 MILL ST MS-M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-1000
  • Fax: 775-982-8046
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO4096
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: