Provider Demographics
NPI:1255696415
Name:HUYNH, RICHARD HIEU TRUNG (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD HIEU
Middle Name:TRUNG
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:RICHARD HIEU
Other - Middle Name:TRUNG
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:4190 CITY AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1629
Mailing Address - Country:US
Mailing Address - Phone:215-871-6694
Mailing Address - Fax:215-871-6695
Practice Address - Street 1:4190 CITY AVE STE 409
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1629
Practice Address - Country:US
Practice Address - Phone:215-871-6694
Practice Address - Fax:215-871-6695
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT015574208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery