Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003086836 |
---|---|
Provider Name | Thuy Truong |
First Address | Garden Grove, CA 92840-5374 |
Second Address | Orange, CA 92868-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2008 |
Last Update Date | 07/03/2008 |