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General NPI Number Information
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NPI Number | 1447296363
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Entity Type | Organization
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Legal Business Name | ACADEMY SKIN PHYSICIANS, INC.
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4510 EXECUTIVE DR SUITE 210
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City | SAN DIEGO
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State | CA
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Zip | 92121-3021
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Country | US
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Telephone | 858-452-1430
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Fax | 858-452-0651
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Provider Business Mailing Address
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Address Line | 4510 EXECUTIVE DR SUITE 210
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City | SAN DIEGO
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State | CA
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Zip | 92121-3021
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Country | US
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Telephone | 858-452-1430
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Fax | 858-452-0651
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALIZABETH LECHI TRUONG
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Credential | M.D.
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Telephone | 858-452-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A68200
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | A65177
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License Number State | CA
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