Provider Demographics
NPI:1891536264
Name:DUONG, CALVIN (AUD)
Entity type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:DUONG
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SAINT PAUL AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2750
Mailing Address - Country:US
Mailing Address - Phone:612-426-0004
Mailing Address - Fax:
Practice Address - Street 1:7380 FRANCE AVE S STE 200
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4506
Practice Address - Country:US
Practice Address - Phone:952-295-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528696231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist