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General NPI Number Information
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NPI Number | 1942832878
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Entity Type | Individual
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Provider Name | AN D. LUONG DPT
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Gender | Male
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Dates
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Enumeration Date | 02/08/2020
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 1524 MCHENRY AVE
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City | MODESTO
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State | CA
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Zip | 95350-4500
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Country | US
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Telephone | 408-320-9092
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 MCHENRY AVE STE 445
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City | MODESTO
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State | CA
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Zip | 95350-4573
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Country | US
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Telephone | 408-320-9092
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 298047
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License Number State | CA
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