MEDICARE: DANH CONG TRUONG M.D., MPH

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	207Q00000X	Family Medicine Physician	A42494	CA

General Provider Information

NPI Number	:	1669406765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANH CONG TRUONG M.D., MPH

Provider Business Mailing Address
First Line	:	4310 EUCLID AVE
Second Line	:	SUITE D & E
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4995
Country	:	US
Telephone Number	:	619-584-4048
Fax Number	:	619-280-3827

Provider Business Practice Location Address
First Line	:	4310 EUCLID AVE
Second Line	:	SUITE D & E
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4995
Country	:	US
Telephone Number	:	619-584-4048
Fax Number	:	619-280-3827

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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