Provider Demographics
NPI:1013100874
Name:TRUONG, LAN THUY
Entity Type:Individual
Prefix:DR
First Name:LAN
Middle Name:THUY
Last Name:TRUONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAN
Other - Middle Name:THUY
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1101 N CHERRY ST
Mailing Address - Street 2:OB/GYN DEPARTMENT
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2231
Mailing Address - Country:US
Mailing Address - Phone:909-379-8487
Mailing Address - Fax:
Practice Address - Street 1:1101 N CHERRY ST
Practice Address - Street 2:OB/GYN DEPARTMENT
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2231
Practice Address - Country:US
Practice Address - Phone:909-379-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT191841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology