Healthcare Provider Details

I. General information

NPI: 1649776188
Provider Name (Legal Business Name): DUC H TRUONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 04/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 105
SAN FRANCISCO CA
94115-2374
US

IV. Provider business mailing address

355 EDDY ST APT 203
SAN FRANCISCO CA
94102-2635
US

V. Phone/Fax

Practice location:
  • Phone: 415-441-5742
  • Fax:
Mailing address:
  • Phone: 206-234-5833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number77252
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: