Healthcare Provider Details

I. General information

NPI: 1235998733
Provider Name (Legal Business Name): PHONG TRUONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BHC OCEANA 1550 TOMCAT BLVD
VIRGINIA BEACH VA
23460
US

IV. Provider business mailing address

BHC OCEANA 1550 TOMCAT BLVD
VIRGINIA BEACH VA
23460
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-3779
  • Fax:
Mailing address:
  • Phone: 757-953-3779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: