Provider Demographics
NPI:1205364569
Name:DOAN, CALVIN TRIET (DO)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:TRIET
Last Name:DOAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 S HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6428
Mailing Address - Country:US
Mailing Address - Phone:949-535-0061
Mailing Address - Fax:
Practice Address - Street 1:2929 S HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6428
Practice Address - Country:US
Practice Address - Phone:949-535-0061
Practice Address - Fax:714-242-7554
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16733207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine