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General NPI Number Information
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NPI Number | 1114236635
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Entity Type | Organization
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Legal Business Name | THOA TRONG DO MD PROF. CORP.
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 14350 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4608
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Country | US
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Telephone | 714-839-0294
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Fax | 714-839-1082
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Provider Business Mailing Address
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Address Line | 14350 BROOKHURST ST
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City | GARDEN GROVE
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State | CA
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Zip | 92843-4608
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Country | US
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Telephone | 714-839-0294
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Fax | 714-839-1082
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOA TRONG DO
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Credential | MD
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Telephone | 714-839-0294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A43520
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License Number State | CA
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