Provider Demographics
NPI:1114454261
Name:TRUONG, NORMAN (PT, DPT, CSCS)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:
Last Name:TRUONG
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 S LEMON AVE
Mailing Address - Street 2:UNIT 203
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91788-2608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 S LEMON AVE
Practice Address - Street 2:UNIT 203
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91788-2608
Practice Address - Country:US
Practice Address - Phone:909-391-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293627225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist