MEDICARE: DANIEL TRUONG O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OD60472718	WA
2	152W00000X	Optometrist	1126	NV

General Provider Information

NPI Number	:	1013226190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL TRUONG O.D.

Provider Business Mailing Address
First Line	:	6230 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3916
Country	:	US
Telephone Number	:	702-737-3937
Fax Number	:	702-737-8860

Provider Business Practice Location Address
First Line	:	6230 N DURANGO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3916
Country	:	US
Telephone Number	:	702-737-3937
Fax Number	:	702-737-8860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2010
Last Update Date	:	03/06/2023

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