MEDICARE: ANH NGOC TRAN 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
1	2084P0800X	Psychiatry Physician	A105097	CA

General Provider Information

NPI Number	:	1609815372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANH NGOC TRAN MD

Provider Business Mailing Address
First Line	:	330 CRESCENT VILLAGE CIR
Second Line	:	APT # 2215
City	:	SAN JOSE
State	:	CA
Zip	:	95134-3500
Country	:	US
Telephone Number	:	408-684-4588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 E 4TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3910
Country	:	US
Telephone Number	:	714-796-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	02/05/2014

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