Provider Demographics
NPI:1437325479
Name:DUONG, CONNOR MINH-KHOI (MD)
Entity Type:Individual
Prefix:DR
First Name:CONNOR
Middle Name:MINH-KHOI
Last Name:DUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MINH-KHOI
Other - Middle Name:
Other - Last Name:DUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7046 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3026
Mailing Address - Country:US
Mailing Address - Phone:818-987-3748
Mailing Address - Fax:
Practice Address - Street 1:6 VENTURE
Practice Address - Street 2:SUITE 350
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3340
Practice Address - Country:US
Practice Address - Phone:949-753-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1071132084P0800X, 2084P0802X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry