# THAN V. TRUONG

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568608222
- **Authorized official:** DR. THAN VAN TRUONG DPM (PODIATRIST)
- **Authorized official phone:** (310) 675-0900

## Contact information

- **Practice address:** 13624 HAWTHORNE BLVD., SUITE 206, HAWTHORNE, CA 90250
- **Practice address phone:** (310) 675-0900
- **Mailing address:** 17810 OSAGE AVE, TORRANCE, CA 90504
- **Mailing address phone:** (310) 994-9783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | E4636 | CA | Yes |

## Other

- **Enumeration date:** 12/31/2008
- **Last updated:** 12/31/2008