Provider Demographics
NPI:1528086279
Name:NGUYEN, TRUNG D (MD)
Entity type:Individual
Prefix:
First Name:TRUNG
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 N WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4830
Mailing Address - Country:US
Mailing Address - Phone:909-883-8686
Mailing Address - Fax:909-881-6537
Practice Address - Street 1:1869 N WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4830
Practice Address - Country:US
Practice Address - Phone:909-883-8686
Practice Address - Fax:909-881-6537
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82169207XS0106X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery