Basic Information
| Provider Information | |||||||||
| NPI: | 1689056780 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUONG | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 625 34TH ST STE 100&200 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933012305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8336782781 | ||||||||
| FaxNumber: | 6613680618 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 34TH ST STE 100&200 | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933012305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8336782781 | ||||||||
| FaxNumber: | 6613680618 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2015 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 15306 | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.