Provider Demographics
NPI:1376436048
Name:TRUONG, KENNETH (PHARMD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11003 GALAX ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-3947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-353-1154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA863091835E0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency MedicineGroup - Single Specialty