Provider Demographics
NPI:1649776188
Name:TRUONG, DUC H (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DUC
Middle Name:H
Last Name:TRUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 EDDY ST APT 203
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-2635
Mailing Address - Country:US
Mailing Address - Phone:206-234-5833
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 105
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2374
Practice Address - Country:US
Practice Address - Phone:415-441-5742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA772521835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77252OtherCALIFORNIA BOARD OF PHARMACY - PHARMACIST LICENSE