Healthcare Provider Details

I. General information

NPI: 1700514460
Provider Name (Legal Business Name): ALINA TRAN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20045 N 19TH AVE STE 166
PHOENIX AZ
85027-4254
US

IV. Provider business mailing address

31 W PASADENA AVE UNIT 8
PHOENIX AZ
85013-2051
US

V. Phone/Fax

Practice location:
  • Phone: 405-370-5572
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD-001163
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: