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General NPI Number Information
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NPI Number | 1649308990
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Entity Type | Organization
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Legal Business Name | QUYNH HOA TRUONG, O.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 19051 GOLDENWEST ST SUITE 102
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-2155
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Country | US
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Telephone | 714-698-2626
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Fax | 714-698-2628
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Provider Business Mailing Address
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Address Line | 22 DEL PADRE
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City | FOOTHILL RANCH
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State | CA
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Zip | 92610-1839
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Country | US
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Telephone | 949-454-9786
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | QUYNH HOA THI TRUONG
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Credential | O.D.
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Telephone | 714-698-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9688T
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License Number State | CA
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