NPI Code Detail JSON Logo

1629573548 NPI number — DUC THANH DOAN DO

NPI Number: 1629573548
Health Care Provider/Practitioner: DUC THANH DOAN DO

Information about “1629573548” NPI (DUC THANH DOAN DO) exists in 1629573548 in HTML format HTML  |  1629573548 in plain Text format TXT  |  1629573548 in PDF (Portable Document Format) PDF  |  1629573548 in an XML format XML  formats.

NPI Number : 1629573548 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629573548",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOAN",
    "FirstName": "DUC",
    "MiddleName": "THANH",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "12692 RANCHERO WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GARDEN GROVE",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92843-3027",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7305 N MILITARY TRL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RIVIERA BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33410-7417",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-422-6957",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/25/2018",
    "LastUpdateDate": "12/05/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": "20A17786",
          "LicenseNumberStateCode": "CA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207QA0401X",
          "TaxonomyName": "Addiction Medicine (Family Medicine) Physician",
          "LicenseNumber": "OS20297",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.