Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 35711 | CA |
NPI | 1043359235 |
---|---|
Provider Name | Huong Lan Duong |
First Address | San Diego, CA 92128 |
Second Address | San Diego, CA 92128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 08/07/2007 |