Healthcare Provider Details

I. General information

NPI: 1275706996
Provider Name (Legal Business Name): NHAN THANH TRUONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 S TOPANGA DR
ANAHEIM CA
92804-1608
US

IV. Provider business mailing address

441 NORTH LAKEVIEW AVE
ANAHEIM CA
92807-1608
US

V. Phone/Fax

Practice location:
  • Phone: 714-816-9228
  • Fax:
Mailing address:
  • Phone: 714-279-4382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH 55706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: