Phu Van Dang, MD & Pauline Suong Thi Dang, MD, a Prof Medical Corp

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A65421 Issued in CA

Legal business name

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

Practice address

13872 Harbor Blvd
Unit 1C
Garden Grove, CA 92843-4000

Phone

(714) 531-5201

Fax

(714) 775-2849

NPI assigned

Jun 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Phu Van Dang, M.D.

Title

President

Phone

(714) 531-5201

Specialties & licenses 3

Addresses

Other names 1

• Bolsa-Ward Medical Clinic, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• An Quoc Dang, M.D.

  • Nephrology Physician
  • Garden Grove, CA
  • NPI 1952302564
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1093918872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13872 HARBOR BLVD",
            "address_2": "UNIT 1C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434000",
            "telephone_number": "714-531-5201",
            "fax_number": "714-775-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13872 HARBOR BLVD",
            "address_2": "UNIT 1C",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928434000",
            "telephone_number": "714-531-5201",
            "fax_number": "714-775-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHU VAN DANG, MD & PAULINE SUONG THI DANG, MD, A PROF MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "PHU",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-531-5201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A41591",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A42349",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A65421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolsa-Ward Medical Clinic, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carmen Sabri Philip
• Patricia Phillips
• Phoenix Star Insurance
• Teve Thongvanh Phommavongsa
• Andrew Phou
• Jennie Soi Phui, RDHAP
• Y Phun, MS
• Anh-Thu Thi Phung, M.D.
• Anne Marie Phung
• Hao My Phung

• Nephrology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.