Provider Demographics
NPI:1740391556
Name:D. JAY DUONG, MD, INC.
Entity Type:Organization
Organization Name:D. JAY DUONG, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAIHUNG
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-863-1314
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:12567 HESPERIA BLVD.
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5847
Practice Address - Country:US
Practice Address - Phone:760-241-7754
Practice Address - Fax:760-962-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A858450Medicare ID - Type UnspecifiedPROVIDER NUMBER
CAES689AMedicare PIN
CAI08348Medicare UPIN