Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A40242 | CA |
NPI | 1003868886 |
---|---|
Provider Name | Dr. Thanhmai Duong |
First Address | Sacramento, CA 95814-6414 |
Second Address | San Jose, CA 95134-2299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F21096 | (02) |