Provider Demographics
NPI:1215982756
Name:DUONG, ANH TUAN (MD)
Entity type:Individual
Prefix:
First Name:ANH
Middle Name:TUAN
Last Name:DUONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35900 BOB HOPE DR
Mailing Address - Street 2:STE 275
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1766
Mailing Address - Country:US
Mailing Address - Phone:760-321-2500
Mailing Address - Fax:760-321-5720
Practice Address - Street 1:35900 BOB HOPE DR
Practice Address - Street 2:STE 275
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1766
Practice Address - Country:US
Practice Address - Phone:760-321-2500
Practice Address - Fax:760-321-5720
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G781520207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G781520Medicare PIN