| Thoa Trong Do Md Prof. Corp. | |
|
14350 Brookhurst St Garden Grove CA 92843-4608 | |
| (714) 839-0294 | |
| (714) 839-1082 |
| Full Name | Thoa Trong Do Md Prof. Corp. |
|---|---|
| Speciality | Clinic/Center |
| Location | 14350 Brookhurst St, Garden Grove, California |
| Authorized Official Name and Position | Thoa Trong Do (PRESIDENT) |
| Authorized Official Contact | 7148390294 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thoa Trong Do Md Prof. Corp. 14350 Brookhurst St Garden Grove CA 92843-4608 Ph: (714) 839-0294 | Thoa Trong Do Md Prof. Corp. 14350 Brookhurst St Garden Grove CA 92843-4608 Ph: (714) 839-0294 |
| NPI Number | 1114236635 |
|---|---|
| Provider Enumeration Date | 10/01/2010 |
| Last Update Date | 10/01/2010 |
| Medicare PECOS PAC ID | 2365635513 |
|---|---|
| Medicare Enrollment ID | O20101021000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114236635 | NPI | - | NPPES |
| 00A435200 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A43520 (California) | Primary |
| Provider Name | Thoa Trong Do |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982719597 PECOS PAC ID: 7416071642 Enrollment ID: I20100825000461 |
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