Provider Demographics
NPI:1174760177
Name:DUONG AND PHAM MED CORP
Entity type:Organization
Organization Name:DUONG AND PHAM MED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:714-697-9939
Mailing Address - Street 1:P.O. BOX 12174
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-2174
Mailing Address - Country:US
Mailing Address - Phone:714-697-9939
Mailing Address - Fax:
Practice Address - Street 1:10138 GARVEY AVE
Practice Address - Street 2:C
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-5002
Practice Address - Country:US
Practice Address - Phone:626-442-6664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4237332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies