Provider Demographics
NPI:1619094059
Name:DOAN, TRINH M (PT)
Entity Type:Individual
Prefix:
First Name:TRINH
Middle Name:M
Last Name:DOAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-0676
Mailing Address - Country:US
Mailing Address - Phone:562-865-2400
Mailing Address - Fax:562-865-2405
Practice Address - Street 1:10802 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1502
Practice Address - Country:US
Practice Address - Phone:562-865-2400
Practice Address - Fax:562-865-2405
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA24922OtherPHYSICAL THERAPIST
CA24922OtherPHYSICAL THERAPIST
CAW 19397Medicare ID - Type Unspecified