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General NPI Number Information
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NPI Number | 1588958805
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Entity Type | Individual
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Provider Name | DUC ANH TIEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE #NA-23
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-5690
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Fax |
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Provider Business Mailing Address
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Address Line | 29 OAKMONT DR
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City | DALY CITY
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State | CA
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Zip | 94015-3541
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Country | US
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Telephone | 415-846-7489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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