Provider Demographics
NPI:1821280744
Name:TRUONG D. DUONG M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TRUONG D. DUONG M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUONG
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:DUONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-744-7983
Mailing Address - Street 1:PO BOX 2077
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91708-2077
Mailing Address - Country:US
Mailing Address - Phone:877-773-8664
Mailing Address - Fax:877-773-8640
Practice Address - Street 1:9333 BASELINE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1350
Practice Address - Country:US
Practice Address - Phone:877-773-8664
Practice Address - Fax:877-773-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70137207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty