Provider Demographics
NPI:1962165902
Name:DOAN, DUY THE
Entity type:Individual
Prefix:
First Name:DUY
Middle Name:THE
Last Name:DOAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N SUNNYVALE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4318
Mailing Address - Country:US
Mailing Address - Phone:559-670-0593
Mailing Address - Fax:
Practice Address - Street 1:1155 AIRPORT PARK BLVD
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5998
Practice Address - Country:US
Practice Address - Phone:707-468-0258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist