NPI |
1245354844 |
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only. |
Entity Type Code |
1 |
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider
is or has been known by a different last name only. |
Provider Last Name Legal Name |
DANH |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
TUYET |
The first name of the provider, if the provider
is an individual. |
Provider First Line Business Practice Location Address |
6101 CERRITOS AVE |
The first name of the provider, if the provider
is an individual. |
Provider Business Practice Location Address City Name |
LONG BEACH |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
CA |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
908053028 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Telephone Number |
5628104551 |
The telephone number associated with the location address of the provider being identified. |
Provider Enumeration Date |
3/19/2007 |
The telephone number associated with the location address of the provider being identified. |
Last Update Date |
7/8/2007 |
The date that a record was last updated or changed. |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
225400000X |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
N |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |