MEDICARE: PAVEENA DOAN N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95002603	CA

General Provider Information

NPI Number	:	1225400146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAVEENA DOAN N.P.

Provider Business Mailing Address
First Line	:	2929 S HARBOR BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6428
Country	:	US
Telephone Number	:	626-696-5156
Fax Number	:

Provider Business Practice Location Address
First Line	:	2929 S HARBOR BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6428
Country	:	US
Telephone Number	:	626-696-5156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	12/02/2025

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