MEDICARE: TRONG QVANG TRINH DO

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	207Q00000X	Family Medicine Physician	20A7445	CA

General Provider Information

NPI Number	:	1295718054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRONG QVANG TRINH DO

Provider Business Mailing Address
First Line	:	PO BOX 187
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-0187
Country	:	US
Telephone Number	:	209-892-9100
Fax Number	:	209-892-9102

Provider Business Practice Location Address
First Line	:	1108 WARD AVE
Second Line	:	BLDG A STE 1
City	:	PATTERSON
State	:	CA
Zip	:	95363-8529
Country	:	US
Telephone Number	:	209-892-9100
Fax Number	:	209-892-9102

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	03/07/2023

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Directions to “ TRONG QVANG TRINH DO” Practice Location

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