Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Phuc Son Si Dong, DO

Individual provider Family Medicine Physician · NPI 1598077869

Dr. Phuc Son Si Dong, DO is a Family Practice in Roseville, California. Qualified in 2010, 16 years ago. Practices with Dignity Health Medical Foundation, a 1,204-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
16
Licensed in
CA
In the registry since
2010
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3980 Douglas Blvd Ste 110
Roseville, CA 95661-4263
Phone: (916) 293-4400
Fax: (916) 293-4401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20A12891 (CA)

Record details

NPI number1598077869
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 2, 2010
Last updated in NPPESFebruary 14, 2024
Certification dateFebruary 14, 2024
Mailing address3400 Data Dr, Rancho Cordova, CA 95670-7956

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Dignity Health Medical Foundation — 1204 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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