Provider Demographics
NPI:1164739603
Name:TRUONG, JOHN QUANG (PHARMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:QUANG
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 1:6557 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4108
Mailing Address - Country:US
Mailing Address - Phone:562-789-5401
Mailing Address - Fax:562-967-2978
Practice Address - Street 1:6557 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4108
Practice Address - Country:US
Practice Address - Phone:562-789-5401
Practice Address - Fax:562-967-2978
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17853183500000X
CA651021835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist