MEDICARE: TRI TRUONG, MD

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	07936126135097	NV

General Provider Information

NPI Number	:	1508068354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI TRUONG, MD

Provider Business Mailing Address
First Line	:	341 N BUFFALO DR
Second Line	:	SUITE B
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-0376
Country	:	US
Telephone Number	:	702-228-5691
Fax Number	:	702-228-5653

Provider Business Practice Location Address
First Line	:	2354 E BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-3451
Country	:	US
Telephone Number	:	702-399-9161
Fax Number	:	702-399-9125

Authorized Official
Title or Position	:	OWNER
Name	:	TRI MINH TRUONG
Credential	:	M.D.
Telephone Number	:	702-399-9161

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	08/22/2020

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Directions to “TRI TRUONG, MD ” Practice Location

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