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NPI Code Detail

MEDICARE: DR. TRUC TRUNG MAI D.M.D

MEDICARE:  DR. TRUC TRUNG MAI  D.M.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
1122300000XDentist44934CA

General Provider Information

NPI Number : 1417928797
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRUC TRUNG MAI D.M.D
Provider Business Mailing Address
First Line : 1161 HIDDEN VALLEY PKWY
Second Line : SUITE 106
City : NORCO
State : CA
Zip : 92860
Country : US
Telephone Number : 957-479-9410
Fax Number : 951-817-0649
Provider Business Practice Location Address
First Line : 1161 HIDDEN VALLEY PKWY
Second Line : SUITE 106
City : NORCO
State : CA
Zip : 92860
Country : US
Telephone Number : 957-479-9410
Fax Number : 951-817-0649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TRUC TRUNG MAI D.M.D” Practice Location

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