Provider Demographics
NPI:1245366558
Name:DUONG, TUAN ANH (MD)
Entity type:Individual
Prefix:DR
First Name:TUAN
Middle Name:ANH
Last Name:DUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1489 WEBSTER ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3766
Mailing Address - Country:US
Mailing Address - Phone:415-775-5700
Mailing Address - Fax:415-775-5755
Practice Address - Street 1:1489 WEBSTER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3766
Practice Address - Country:US
Practice Address - Phone:415-775-5700
Practice Address - Fax:415-775-5755
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA82670207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A826700Medicaid
CA00A826700Medicaid
CAH93360Medicare UPIN