Provider Demographics
NPI:1669406765
Name:TRUONG, DANH CONG (MD, MPH)
Entity type:Individual
Prefix:
First Name:DANH
Middle Name:CONG
Last Name:TRUONG
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 EUCLID AVE
Mailing Address - Street 2:SUITE D & E
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4995
Mailing Address - Country:US
Mailing Address - Phone:619-584-4048
Mailing Address - Fax:619-280-3827
Practice Address - Street 1:4310 EUCLID AVE
Practice Address - Street 2:SUITE D & E
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4995
Practice Address - Country:US
Practice Address - Phone:619-584-4048
Practice Address - Fax:619-280-3827
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine