Provider Demographics
NPI:1598761181
Name:DUONG, DUC H (MD)
Entity Type:Individual
Prefix:
First Name:DUC
Middle Name:H
Last Name:DUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8043 2ND ST
Mailing Address - Street 2:STE 105
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3621
Mailing Address - Country:US
Mailing Address - Phone:562-862-1134
Mailing Address - Fax:562-861-9895
Practice Address - Street 1:8043 2ND ST
Practice Address - Street 2:STE 105
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3621
Practice Address - Country:US
Practice Address - Phone:562-862-1134
Practice Address - Fax:562-861-9895
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG84028207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G840280Medicaid
CAWG84028CMedicare PIN
WG84028BMedicare PIN
CA00G840280Medicaid