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General NPI Number Information
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NPI Number | 1891021606
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Entity Type | Individual
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Provider Name | ANNIE ROSE TRUONG PA
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Gender | Female
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 11180 WARNER AVE STE 351
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7516
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Country | US
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Telephone | 714-968-6788
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Fax |
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Provider Business Mailing Address
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Address Line | 541 W COLORADO ST STE 205
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City | GLENDALE
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State | CA
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Zip | 91204-3640
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA06281
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 52353
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License Number State | CA
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