Provider Demographics
NPI:1699973297
Name:DEWING, JANNE HUYNH (MD)
Entity type:Individual
Prefix:DR
First Name:JANNE
Middle Name:HUYNH
Last Name:DEWING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANNE
Other - Middle Name:MYNGOC
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:31862 COAST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6771
Mailing Address - Country:US
Mailing Address - Phone:949-340-5454
Mailing Address - Fax:949-340-5454
Practice Address - Street 1:31862 COAST HWY STE 200
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6771
Practice Address - Country:US
Practice Address - Phone:949-340-5454
Practice Address - Fax:949-340-5454
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208683207R00000X
CAC52349207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01889005Medicaid
CABP833YMedicare PIN
NY01889005Medicaid
NY275L91Medicare PIN