MEDICARE: DR. THUYQUYEN DOAN D.D.S.

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	122300000X	Dentist	49874	CA
2	1223G0001X	General Practice Dentistry	49874	CA

General Provider Information

NPI Number	:	1609269174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THUYQUYEN DOAN D.D.S.

Provider Business Mailing Address
First Line	:	3780 EL CAJON BLVD # 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1080
Country	:	US
Telephone Number	:	619-265-2467
Fax Number	:	619-265-2196

Provider Business Practice Location Address
First Line	:	3780 EL CAJON BLVD # 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1080
Country	:	US
Telephone Number	:	619-265-2467
Fax Number	:	619-265-2196

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

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	10/31/2024

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Directions to “ DR. THUYQUYEN DOAN D.D.S.” Practice Location

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