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PHU VAN DANG MD & PAULINE SUONG THI DANG MD A PROF MEDICAL CORP NPI 1093918872


NPI Information

NPI: 1093918872
Provider Name: PHU VAN DANG, MD & PAULINE SUONG THI DANG, MD, A PROF MEDICAL CORP

Doing Business As: BOLSA-WARD MEDICAL CLINIC, INC.

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
13872 HARBOR BLVD
UNIT 1C
GARDEN GROVE, CA
ZIP 92843
Phone: (714) 531-5201
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PHU VAN DANG, MD & PAULINE SUONG THI DANG, MD, A PROF MEDICAL CORP is a nephrology internal medicine in Garden Grove, CA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. PHU VAN DANG, MD & PAULINE SUONG THI DANG, MD, A PROF MEDICAL CORP NPI is 1093918872. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bolsa-ward Medical Clinic, Inc..

The provider's business location address is:

13872 HARBOR BLVD
UNIT 1C
GARDEN GROVE, CA
ZIP 92843-000
Phone: (714) 531-5201
Fax: (714) 775-2849

The provider's authorized official is Phu Van Dang .
The authorized official title is President and has the following contact phone number (714) 531-5201.

The enumeration date for this NPI number is 6/7/2007 and was last updated on 5/20/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineA41591CALIFORNIANo
2207Q00000XFamily MedicineA42349CALIFORNIANo
3207RN0300XInternal MedicineNephrologyA65421CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W13435MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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