Basic Information
| Provider Information | |||||||||
| NPI: | 1922033729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUONG | ||||||||
| FirstName: | TRUONG | ||||||||
| MiddleName: | DINH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1731 3RD ST | ||||||||
| Address2: | |||||||||
| City: | NORCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928602670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9517850600 | ||||||||
| FaxNumber: | 9093850379 | ||||||||
| Practice Location | |||||||||
| Address1: | 1731 3RD ST | ||||||||
| Address2: | |||||||||
| City: | NORCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928602670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8777738664 | ||||||||
| FaxNumber: | 8777738640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | A70137 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | A70137 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 00A701373 | 05 | CA | MEDICAID |