Healthcare Provider Details

I. General information

NPI: 1518020353
Provider Name (Legal Business Name): ANTHONY LEMINH TRUONG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 W FOOTHILL BLVD 209
UPLAND CA
91786
US

IV. Provider business mailing address

299 W FOOTHILL BLVD 209
UPLAND CA
91786
US

V. Phone/Fax

Practice location:
  • Phone: 909-982-4000
  • Fax:
Mailing address:
  • Phone: 909-982-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number20A20836
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036132077
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A20836
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: