Provider Demographics
NPI:1801070156
Name:TRUONG, BRIAN C (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:TRUONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1550 S PIONEER WAY SUITE 115
Mailing Address - Street 2:ASSOCIATION OF SAMARITAN PHYSICIANS
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837
Mailing Address - Country:US
Mailing Address - Phone:509-793-9773
Mailing Address - Fax:509-764-3261
Practice Address - Street 1:1550 S PIONEER WAY SUITE 205
Practice Address - Street 2:SAMARITAN OB/GYN
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837
Practice Address - Country:US
Practice Address - Phone:509-793-9786
Practice Address - Fax:509-764-3257
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101325207V00000X
WAMD60291321207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology