Provider Demographics
NPI:1518285196
Name:TRUONG, PETER
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13950 MILTON AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-2900
Mailing Address - Country:US
Mailing Address - Phone:714-901-4629
Mailing Address - Fax:714-901-4639
Practice Address - Street 1:13950 MILTON AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-2900
Practice Address - Country:US
Practice Address - Phone:714-901-4629
Practice Address - Fax:714-901-4639
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner