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General NPI Number Information
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NPI Number | 1639831928
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Entity Type | Organization
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Legal Business Name | DUONG MEDICAL LLC
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 611 E ANAHEIM ST
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City | LONG BEACH
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State | CA
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Zip | 90813-3301
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Country | US
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Telephone | 562-231-6232
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Fax | 216-208-1535
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Provider Business Mailing Address
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Address Line | 6384 GRANT CT
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City | CHINO
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State | CA
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Zip | 91710-3708
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Country | US
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Telephone | 909-413-1531
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KHANH DUONG
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Credential | MD
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Telephone | 909-413-1531
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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 |
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License Number State |
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