MEDICARE: CHRISTINE TRUONG, OD, OPTOMETRIC CORPORATION

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1396444147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE TRUONG, OD, OPTOMETRIC CORPORATION

Provider Business Mailing Address
First Line	:	6511 E PACIFIC COAST HWY STE G2B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4250
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6511 E PACIFIC COAST HWY STE G2-B
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-4248
Country	:	US
Telephone Number	:	714-618-1917
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. CHRISTINE TRUONG
Credential	:
Telephone Number	:	562-358-3616

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	09/27/2023

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