Healthcare Provider Details

I. General information

NPI: 1366075640
Provider Name (Legal Business Name): DZUNG TRINH, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2020
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: 559-908-8415
  • Fax: 559-550-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DZUNG TRINH
Title or Position: CEO
Credential: MD
Phone: 559-550-4344