Provider Demographics
NPI:1841372315
Name:DUONG, THUC HUU (MD)
Entity type:Individual
Prefix:DR
First Name:THUC
Middle Name:HUU
Last Name:DUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 E SOUTHGATE DR
Mailing Address - Street 2:STE. D
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2609
Mailing Address - Country:US
Mailing Address - Phone:916-428-7990
Mailing Address - Fax:916-428-1334
Practice Address - Street 1:7260 E SOUTHGATE DR
Practice Address - Street 2:STE. D
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2609
Practice Address - Country:US
Practice Address - Phone:916-428-7990
Practice Address - Fax:916-428-1334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA051790208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A517900Medicaid
CA610040OtherRCMG
CAG01251OtherBLUE CROSS
CAF71725Medicare UPIN
CAG01251OtherBLUE CROSS