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NPI Code Detail

MEDICARE: DR. DEAN QUANG TRINH MD

MEDICARE: DR. DEAN QUANG TRINH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist37701MN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00073720OTHERMNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1165302OTHERMNUCARE

General Provider Information

NPI Number : 1134119324
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN QUANG TRINH MD
Provider Business Mailing Address
First Line : 2800 CAMPUS DR
Second Line : SUITE 150
City : PLYMOUTH
State : MN
Zip : 55441-2606
Country : US
Telephone Number : 763-201-0492
Fax Number :
Provider Business Practice Location Address
First Line : 111 17TH AVE E
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-3703
Country : US
Telephone Number : 320-762-6073
Fax Number : 320-762-6145
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 04/28/2008

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Directions to “ DR. DEAN QUANG TRINH MD” Practice Location

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