Provider Demographics
NPI:1922302116
Name:TRUONG, CYNTHIA NGA (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:NGA
Last Name:TRUONG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 ONTARIO DR APT 6
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-5450
Mailing Address - Country:US
Mailing Address - Phone:408-431-6136
Mailing Address - Fax:
Practice Address - Street 1:6815 CAMINO ARROYO STE 60
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7077
Practice Address - Country:US
Practice Address - Phone:408-842-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-01
Last Update Date:2011-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14048 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist