Individual provider Active NPI

Bong Doan, M.D.

  • Psychiatry Physician
  • Westminster, CA
National Provider Identifier
1528021516
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A45613 Issued in CA
Practice address
14140 Beach Blvd Ste 200
Westminster, CA 92683-4453
Phone
(714) 896-7566
NPI assigned
Apr 10, 2006
Last updated
Nov 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X A45613 CA
Psychiatry Physician 2084P0800X A45613 CA Primary

Addresses

Primary practice location

14140 Beach Blvd Ste 200
Westminster, CA 92683-4453

Mailing address

14140 Beach Blvd Ste 200
Westminster, CA 92683-4453
Phone (714) 896-7566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091119000284 CA Practitioner - Psychiatry 2466590039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OrangeGroup PAC ID 1951215789, 45 clinicians

Practice addresses (Care Compare)

14140 Beach Blvd
Suite 223
Westminster, CA 92683-4453
Phone (714) 896-7566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45613CAMDGeneral Practice Dentistry
A45613CAMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Orange Current Accepting new patients
County of Orange CurrentSince Aug 14, 2017 Accepting new patients
South Coast Children's Society, Inc Past Accepting new patients
County of Orange PastSince Nov 9, 2021 Accepting new patients
South Coast Children's Society, Inc Past Accepting new patients

Locations

23228 Madero
Mission Viejo, CA 92691
Phone (949) 454-3940

14140 Beach Blvd
Ste 223
Westminster, CA 92683
Phone (714) 896-7566

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1528021516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14140 BEACH BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834453",
            "telephone_number": "714-896-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14140 BEACH BLVD STE 200",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834453",
            "telephone_number": "714-896-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "BONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2021-11-01",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "CA",
            "license": "A45613",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A45613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.