Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | G58851 | CA |
NPI | 1023096765 |
---|---|
Provider Name | Michael Pm Truong |
First Address | Mission Viejo, CA 92691-8038 |
Second Address | Mission Viejo, CA 92691-6384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G588510 | (05) | CA |
A53450 | (02) | CA |