MEDICARE: DR. CHI 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
1	208000000X	Pediatrics Physician	G77728	CA

General Provider Information

NPI Number	:	1649262718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHI TRUONG MD

Provider Business Mailing Address
First Line	:	17100 EUCLID ST
Second Line	:	DEPT. PICU
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-4004
Country	:	US
Telephone Number	:	714-966-7253
Fax Number	:	714-966-3354

Provider Business Practice Location Address
First Line	:	17100 EUCLID ST
Second Line	:	DEPT. PICU
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-4004
Country	:	US
Telephone Number	:	714-966-7253
Fax Number	:	714-966-3354

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	02/13/2023

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