Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A140896 | CA |
NPI | 1013334168 |
---|---|
Provider Name | Brian Truong |
First Address | Los Angeles, CA 90095-4110 |
Second Address | Los Angeles, CA 90095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 06/11/2019 |