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NPI Code Detail

MEDICARE: TINA TRUONG

MEDICARE:   TINA  TRUONG
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
1183500000XPharmacist88605CA

General Provider Information

NPI Number : 1649135112
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA TRUONG
Provider Business Mailing Address
First Line : 2312 STANISLAUS CT
Second Line :
City : SAN JOSE
State : CA
Zip : 95133-1229
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2221 ENBORG LN STE 1J018
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2608
Country : US
Telephone Number : 408-793-6141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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Directions to “ TINA TRUONG ” Practice Location

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