1043900368 NPI number — DR. DOAN PHUONG QUYNH PHARMD

Table of content: DR. DOAN PHUONG QUYNH PHARMD (NPI 1043900368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043900368 NPI number — DR. DOAN PHUONG QUYNH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUYNH
Provider First Name:
DOAN
Provider Middle Name:
PHUONG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOAN
Provider Other First Name:
QUYNH
Provider Other Middle Name:
PHUONG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043900368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3237 E CHAPMAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92869-3709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-538-5609
Provider Business Mailing Address Fax Number:
714-538-0335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3237 E CHAPMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92869-3709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-538-5609
Provider Business Practice Location Address Fax Number:
714-538-0335
Provider Enumeration Date:
05/10/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  87673 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)