Basic Information
| Provider Information | |||||||||
| NPI: | 1316327125 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRIEU | ||||||||
| FirstName: | ATLAS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1454 INWOOD CT | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950084406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022950462 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 S BROADWAY APT 618 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900154343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067432757 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2015 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R9299 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A156032 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.