Provider Demographics
NPI:1386890663
Name:LAWRENCE TRUONG CHIROPRACTIC INC
Entity type:Organization
Organization Name:LAWRENCE TRUONG CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-560-4460
Mailing Address - Street 1:5252 BALBOA AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6906
Mailing Address - Country:US
Mailing Address - Phone:858-560-4460
Mailing Address - Fax:
Practice Address - Street 1:5252 BALBOA AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-6906
Practice Address - Country:US
Practice Address - Phone:858-560-4460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty