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General NPI Number Information
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NPI Number | 1033018858
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Entity Type | Organization
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Legal Business Name | AVANTA MEDICAL ASSOCIATES, PC
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 11420 WARNER AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-2529
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Country | US
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Telephone | 714-839-2896
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CITY PKWY W STE 800
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City | ORANGE
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State | CA
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Zip | 92868-2948
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Country | US
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Telephone | 888-505-4815
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KIEN-AN DUONG
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Credential | MD
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Telephone | 714-553-9320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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