MEDICARE: DR. TRUC THI TRINH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	0101237355	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101237355	OTHER	VA	STATE LICENSE

General Provider Information

NPI Number	:	1063441863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRUC THI TRINH M.D.

Provider Business Mailing Address
First Line	:	1910 ARMAND CT
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22043-1758
Country	:	US
Telephone Number	:	703-522-0751
Fax Number	:	703-528-4209

Provider Business Practice Location Address
First Line	:	1715 N GEORGE MASON DR
Second Line	:	SUITE 204
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3609
Country	:	US
Telephone Number	:	703-522-0751
Fax Number	:	703-528-4209

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/09/2012

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Directions to “ DR. TRUC THI TRINH M.D.” Practice Location

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