Provider Demographics
NPI:1114398955
Name:MINH CANH DO, MD, INC.
Entity Type:Organization
Organization Name:MINH CANH DO, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:CANH
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-418-0488
Mailing Address - Street 1:4718 W 1ST ST
Mailing Address - Street 2:100
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-3106
Mailing Address - Country:US
Mailing Address - Phone:714-418-0488
Mailing Address - Fax:714-418-1086
Practice Address - Street 1:4718 W 1ST ST
Practice Address - Street 2:100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3106
Practice Address - Country:US
Practice Address - Phone:714-418-0488
Practice Address - Fax:714-418-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45092207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA45092Medicare PIN