Provider Demographics
NPI:1881762219
Name:TRUONG, HENRY HIEN-VAN (PHARMD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:HIEN-VAN
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 1:1289 E HILLSDALE BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1294
Mailing Address - Country:US
Mailing Address - Phone:650-312-1342
Mailing Address - Fax:
Practice Address - Street 1:1289 E HILLSDALE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1294
Practice Address - Country:US
Practice Address - Phone:650-312-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2012-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57474183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist