Provider Demographics
NPI:1114385838
Name:DO, QUYEN
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9862 CHAPMAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-2726
Mailing Address - Country:US
Mailing Address - Phone:714-640-3475
Mailing Address - Fax:
Practice Address - Street 1:9862 CHAPMAN AVE, STE. B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841
Practice Address - Country:US
Practice Address - Phone:714-640-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator