Healthcare Provider Details

I. General information

NPI: 1912672635
Provider Name (Legal Business Name): HILLARY AN TRUONG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21738 US HIGHWAY 18
APPLE VALLEY CA
92307-3916
US

IV. Provider business mailing address

1095 S RESERVOIR ST
POMONA CA
91766-3859
US

V. Phone/Fax

Practice location:
  • Phone: 760-247-1840
  • Fax:
Mailing address:
  • Phone: 909-200-0057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number84364
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42865
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP9204
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: