Provider Demographics
NPI:1497409346
Name:TROUNG MA CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:TROUNG MA CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SULLIVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-760-8168
Mailing Address - Street 1:461 VIOLET ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-3926
Mailing Address - Country:US
Mailing Address - Phone:510-813-8591
Mailing Address - Fax:
Practice Address - Street 1:4847 HOPYARD RD STE D-1
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3360
Practice Address - Country:US
Practice Address - Phone:510-813-8591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service