Provider Demographics
NPI:1881831030
Name:TAN-TRUONG, SOPHIA TSU (MD)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:TSU
Last Name:TAN-TRUONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2550 W MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1694
Mailing Address - Country:US
Mailing Address - Phone:626-457-6900
Mailing Address - Fax:626-457-5022
Practice Address - Street 1:200 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-4516
Practice Address - Country:US
Practice Address - Phone:310-522-8700
Practice Address - Fax:310-549-4546
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2021-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA105263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine