Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A131672 | CA |
NPI | 1023329125 |
---|---|
Provider Name | Kong Truong |
First Address | Fountain Valley, CA 92708-5153 |
Second Address | Fountain Valley, CA 92708-5153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 30/06/2016 |