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NPI Code Detail

MEDICARE: MS. PAULINE DUNG DOAN

MEDICARE: MS. PAULINE DUNG DOAN
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
1183500000XPharmacist69905CA

General Provider Information

NPI Number : 1700201050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAULINE DUNG DOAN
Provider Business Mailing Address
First Line : 13632 NASSAU DR
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-5333
Country : US
Telephone Number : 714-469-7943
Fax Number :
Provider Business Practice Location Address
First Line : 16120 BEAR VALLEY RD
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-8706
Country : US
Telephone Number : 714-469-7943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2014
Last Update Date : 02/24/2014

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