| Doctor Name: | DR. PHUONG CHI TRUONG |
| NPI Number: | 1215054481 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A92179 |
| Business Practice Address: | 205d Shell Ave Fort Walton Beach, FL - 32548 |
| Business Phone Number: | 8508339595 |
| Business Fax Number: | 8508337528 |
| Mailing Address: | 9353 Valley Blvd, ROSEMEAD |
| State: | CA |
| Postal Code: | 917701934 |
| Phone Number: | 6262872988 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2007 |
| NPI Last Update Date: | 03/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084A0401X |
| License Number: | A92179 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |