Provider Demographics
NPI:1457941874
Name:TRUONG, LOYAL LUONG
Entity Type:Individual
Prefix:
First Name:LOYAL
Middle Name:LUONG
Last Name:TRUONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 19TH ST APT 5013
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6081
Mailing Address - Country:US
Mailing Address - Phone:714-234-4631
Mailing Address - Fax:
Practice Address - Street 1:11 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2909
Practice Address - Country:US
Practice Address - Phone:303-399-1146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0003871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist