Provider Demographics
NPI:1952590820
Name:DUC H DO MD INC
Entity Type:Organization
Organization Name:DUC H DO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUC
Authorized Official - Middle Name:H
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-574-4114
Mailing Address - Street 1:307 PLACENTIA AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3310
Mailing Address - Country:US
Mailing Address - Phone:949-574-4114
Mailing Address - Fax:949-574-4144
Practice Address - Street 1:307 PLACENTA AVE
Practice Address - Street 2:202
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-0852
Practice Address - Country:US
Practice Address - Phone:949-574-4114
Practice Address - Fax:949-574-4144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H92812Medicare UPIN