Healthcare Provider Details

I. General information

NPI: 1679651582
Provider Name (Legal Business Name): DZUNG TRINH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 E BARSTOW AVE STE 102
FRESNO CA
93710-6039
US

IV. Provider business mailing address

1090 E KELSO AVE
FRESNO CA
93720-1849
US

V. Phone/Fax

Practice location:
  • Phone: 559-550-4344
  • Fax: 559-550-6011
Mailing address:
  • Phone: 559-906-2962
  • Fax: 559-550-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberG65282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: