Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 30664 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 30664 | CA |
NPI | 1134383185 |
---|---|
Provider Name | Dr. Justin Seang Truong |
First Address | Rowland Heights, CA 91748-4417 |
Second Address | Rowland Heights, CA 91748-4417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2008 |
Last Update Date | 17/07/2008 |