Provider Demographics
NPI:1285931790
Name:DUONG, MARGARETTE THI (FNP)
Entity type:Individual
Prefix:
First Name:MARGARETTE
Middle Name:THI
Last Name:DUONG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9143 VALLEY BLVD
Mailing Address - Street 2:101B
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1991
Mailing Address - Country:US
Mailing Address - Phone:626-237-0135
Mailing Address - Fax:626-237-0136
Practice Address - Street 1:9143 VALLEY BLVD
Practice Address - Street 2:101B
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1991
Practice Address - Country:US
Practice Address - Phone:626-237-0135
Practice Address - Fax:626-237-0136
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20362OtherFNP LICENSE