Basic Information
| Provider Information | |||||||||
| NPI: | 1821280744 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUONG D. DUONG M.D., A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2077 | ||||||||
| Address2: | |||||||||
| City: | CHINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917082077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777738664 | ||||||||
| FaxNumber: | 8777738640 | ||||||||
| Practice Location | |||||||||
| Address1: | 9333 BASELINE RD | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | RANCHO CUCAMONGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917301350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777738664 | ||||||||
| FaxNumber: | 8777738640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2007 | ||||||||
| LastUpdateDate: | 03/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | DUONG | ||||||||
| AuthorizedOfficialFirstName: | TRUONG | ||||||||
| AuthorizedOfficialMiddleName: | DINH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9097447983 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A70137 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.