Provider Demographics
NPI:1861022626
Name:HUYNH, TRUNG Q (OWNER)
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:Q
Last Name:HUYNH
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:TIM
Other - Middle Name:
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEARING SPECIALIST
Mailing Address - Street 1:440 S BREA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5338
Mailing Address - Country:US
Mailing Address - Phone:714-987-3130
Mailing Address - Fax:
Practice Address - Street 1:440 S BREA BLVD STE A
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5338
Practice Address - Country:US
Practice Address - Phone:714-987-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7729237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist