Basic Information
Provider Information
NPI: 1770544827
EntityType: 2
ReplacementNPI:  
OrganizationName: DANNY PHU MD INC
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Mailing Information
Address1: 701 EAST 28TH ST
Address2: SUITE 415
City: LONG BEACH
State: CA
PostalCode: 90806
CountryCode: US
TelephoneNumber: 5629882777
FaxNumber: 5629882779
Practice Location
Address1: 701 EAST 28TH ST
Address2: SUITE 415
City: LONG BEACH
State: CA
PostalCode: 90806
CountryCode: US
TelephoneNumber: 5629882777
FaxNumber: 5629882779
Other Information
ProviderEnumerationDate: 03/29/2006
LastUpdateDate: 01/06/2011
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: PHU
AuthorizedOfficialFirstName: DANNY
AuthorizedOfficialMiddleName: TRIET
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 5629882777
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA75115CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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