Provider Demographics
NPI:1164443768
Name:TRUONG, MONG-HOA
Entity Type:Individual
Prefix:MRS
First Name:MONG-HOA
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 ALUM ROCK AVE
Mailing Address - Street 2:7A
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-2445
Mailing Address - Country:US
Mailing Address - Phone:408-928-5650
Mailing Address - Fax:408-928-5654
Practice Address - Street 1:1695 ALUM ROCK AVE
Practice Address - Street 2:7A
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-2445
Practice Address - Country:US
Practice Address - Phone:408-928-5650
Practice Address - Fax:408-928-5654
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46227207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics