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Individual
JIMMY BO DUONG
Active
Individual
JIMMY BO DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
300856
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300856
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
08/27/2021
Last updated
08/27/2021
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