MEDICARE: KELLY TRAN NP

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	363LF0000X	Family Nurse Practitioner	NP95036021	CA

General Provider Information

NPI Number	:	1730059361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY TRAN NP

Provider Business Mailing Address
First Line	:	600 N GARFIELD AVE STE 308
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1169
Country	:	US
Telephone Number	:	626-288-0889
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N GARFIELD AVE STE 308
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1169
Country	:	US
Telephone Number	:	626-288-0889
Fax Number	:

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

Provider Enumeration Date	:	11/08/2025
Last Update Date	:	01/23/2026

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