Provider Demographics
NPI:1194769232
Name:TRUONG-YUE, PHUONG CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:CATHERINE
Last Name:TRUONG-YUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PHUONG
Other - Middle Name:CATHERINE
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17304 HARVEST AVENUE
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-869-4579
Mailing Address - Fax:562-862-1765
Practice Address - Street 1:8500 FLORENCE AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4056
Practice Address - Country:US
Practice Address - Phone:562-869-4579
Practice Address - Fax:562-862-1765
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG78810207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG36599Medicare UPIN
CAWG78810CMedicare ID - Type Unspecified