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General NPI Number Information
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NPI Number | 1104283878
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Entity Type | Individual
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Provider Name | TRINA QUANG
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Gender | Female
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 14333 TYLER ST 40
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City | SYLMAR
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State | CA
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Zip | 91342-1400
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Country | US
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Telephone | 626-319-4228
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Fax |
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Provider Business Mailing Address
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Address Line | 14333 TYLER ST 40
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City | SYLMAR
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State | CA
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Zip | 91342
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Country | US
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Telephone | 818-362-2708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 29425
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License Number State | CA
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