Healthcare Provider Details

I. General information

NPI: 1205332178
Provider Name (Legal Business Name): CAROLINE MAI-KHANH DOAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 W 31ST ST APT 10F
NEW YORK NY
10001-4507
US

IV. Provider business mailing address

9 W 31ST ST APT 10F
NEW YORK NY
10001-4507
US

V. Phone/Fax

Practice location:
  • Phone: 714-642-7592
  • Fax:
Mailing address:
  • Phone: 714-642-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number313917
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: