Active NPI
Paul L Duong, M.D.
- Radiation Oncology Physician
- Los Angeles, CA
National Provider Identifier
1790750768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Oncology Physician
- License
- A052717
- Practice address
- 200 Medical PLZ
Suite B265
Los Angeles, CA 90095-0001 - Phone
- (310) 825-9771
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Oncology Physician | 2085R0001X | A052717 | CA | Primary |
Addresses
Primary practice location
200 Medical PLZ
Suite B265
Los Angeles, CA 90095-0001
Mailing address
5767 W Century Blvd
Suite 400
Los Angeles, CA 90045-5631
Phone (310) 825-9771
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A527170 | Other | CA | BLUE SHIELD OF CA |
| 1790750768 | Other | CA | MEDI-CAL |
| 7372003 | Other | CA | AETNA |
| 1881133 | Other | CA | CIGNA |
| P01520902 | Other | CA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A052717 | CA | MD | Radiation Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of California a Medical Corporation | Radiation Oncology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Radiation Oncology Physician
- Palm Desert, CA
- NPI 1861472318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1790750768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD",
"address_2": "SUITE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631",
"telephone_number": "310-825-9771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PLZ",
"address_2": "SUITE B265",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900950001",
"telephone_number": "310-825-9771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUONG",
"first_name": "PAUL",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0001X",
"taxonomy_group": "",
"desc": "Radiology, Radiation Oncology",
"state": "CA",
"license": "A052717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "00A527170",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "1790750768",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7372003",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1881133",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01520902",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.