Provider Demographics
NPI:1265848519
Name:DUONG, TAMMY (MD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PARNASSUS AVENUE
Mailing Address - Street 2:BOX GPP-0984
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0984
Mailing Address - Country:US
Mailing Address - Phone:415-476-7527
Mailing Address - Fax:
Practice Address - Street 1:2010 ZONAL AVE
Practice Address - Street 2:#1P10
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1026
Practice Address - Country:US
Practice Address - Phone:323-409-5572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1306092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry