Provider Demographics
NPI:1831200526
Name:DOAN, TUAN A (MD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:A
Last Name:DOAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 SUNSET BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-3781
Mailing Address - Country:US
Mailing Address - Phone:916-872-1818
Mailing Address - Fax:916-282-1696
Practice Address - Street 1:501 E ST
Practice Address - Street 2:
Practice Address - City:WILLIAMS
Practice Address - State:CA
Practice Address - Zip Code:95987-5810
Practice Address - Country:US
Practice Address - Phone:530-619-0393
Practice Address - Fax:916-244-0813
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G778250Medicaid
CA1831200526OtherNORIDIAN
CA1831200526OtherNORIDIAN
G77950Medicare UPIN
CA00G778253Medicare PIN
CA00G778250Medicaid