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General NPI Number Information
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NPI Number | 1528731205
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Entity Type | Organization
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Legal Business Name | TRUECARE MEDICAL LLC
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 625 BEAVER RUIN RD NW STE E
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City | LILBURN
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State | GA
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Zip | 30047-3407
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Country | US
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Telephone | 678-369-9399
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Fax | 833-464-3867
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Provider Business Mailing Address
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Address Line | 625 BEAVER RUIN RD NW STE E
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City | LILBURN
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State | GA
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Zip | 30047-3407
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Country | US
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Telephone | 678-369-9399
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Fax | 770-733-1370
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. NGOC BAO PHAN
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Credential | DO
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Telephone | 678-369-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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