Provider Demographics
NPI:1619964368
Name:DO, MINH CANH (MD)
Entity Type:Individual
Prefix:DR
First Name:MINH
Middle Name:CANH
Last Name:DO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14441 BROOKHURST ST
Mailing Address - Street 2:STE 6
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4646
Mailing Address - Country:US
Mailing Address - Phone:714-408-0488
Mailing Address - Fax:
Practice Address - Street 1:14441 BROOKHURST ST
Practice Address - Street 2:STE 6
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4646
Practice Address - Country:US
Practice Address - Phone:714-408-0488
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA45092207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A450920Medicaid
CAE82101Medicare UPIN
CA00A450920Medicaid