Individual
LONG TRINH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
751 S BASCOM AVE, ATTN: RADIOLOGY DEPT, SAN JOSE, CA 95128-2604
(408) 885-5000
Mailing address
751 S BASCOM AVE, ATTN: RADIOLOGY DEPT, SAN JOSE, CA 95128-2604
(408) 885-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R70165
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
A110279
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A110279
MEDICAL LICENSE
CA
01
—
R70165
TRAINING PERMIT
AZ
Enumeration date
06/16/2008
Last updated
12/01/2022
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