Provider Demographics
NPI:1184991481
Name:TRUONG, EMILY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5368 STARLING DR
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-4471
Mailing Address - Country:US
Mailing Address - Phone:909-568-7163
Mailing Address - Fax:
Practice Address - Street 1:6400 HAVEN AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-3823
Practice Address - Country:US
Practice Address - Phone:909-941-3857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47972183500000X
CA68806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist