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NPI Code Detail

MEDICARE: TRI TRUONG, MD

MEDICARE: TRI TRUONG, MD
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
1207Q00000XFamily Medicine Physician07936126135097NV

General Provider Information

NPI Number : 1508068354
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI TRUONG, MD
Provider Business Mailing Address
First Line : 341 N BUFFALO DR
Second Line : SUITE B
City : LAS VEGAS
State : NV
Zip : 89145-0376
Country : US
Telephone Number : 702-228-5691
Fax Number : 702-228-5653
Provider Business Practice Location Address
First Line : 2354 E BONANZA RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-3451
Country : US
Telephone Number : 702-399-9161
Fax Number : 702-399-9125
Authorized Official
Title or Position : OWNER
Name : TRI MINH TRUONG
Credential : M.D.
Telephone Number : 702-399-9161
Provider Enumeration Date : 06/04/2007
Last Update Date : 08/22/2020

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