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General NPI Number Information
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NPI Number | 1477906717
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Entity Type | Organization
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Legal Business Name | PHUC DANG, MD CORPORATION
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Dates
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Enumeration Date | 07/21/2016
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Last Update Date | 07/21/2016
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Provider Practice Location Address
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Address Line | 1006 MISSION DR APT A SUITE 200
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City | COSTA MESA
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State | CA
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Zip | 92626-4217
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Country | US
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Telephone | 714-442-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 300 OLD RIVER RD SUITE 200
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHUC N DANG
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Credential |
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Telephone | 714-442-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | A117592
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License Number State | CA
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