Provider Demographics
NPI:1831113901
Name:DO, LUONG TRUNG (MD)
Entity Type:Individual
Prefix:
First Name:LUONG
Middle Name:TRUNG
Last Name:DO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:925 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4442
Mailing Address - Country:US
Mailing Address - Phone:626-282-0282
Mailing Address - Fax:626-282-0939
Practice Address - Street 1:193 E ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3487
Practice Address - Country:US
Practice Address - Phone:626-568-3302
Practice Address - Fax:626-568-3419
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA90656208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90656OtherMEDICAL LICENSE