Healthcare Provider Details

I. General information

NPI: 1639977739
Provider Name (Legal Business Name): TROY TU-TRONG MINH LA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 W 3RD ST STE 1070W
LOS ANGELES CA
90048-6137
US

IV. Provider business mailing address

8635 W 3RD ST STE 1070W
LOS ANGELES CA
90048-6137
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-4700
  • Fax:
Mailing address:
  • Phone: 310-423-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberPTL20836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: