Healthcare Provider Details

I. General information

NPI: 1235833906
Provider Name (Legal Business Name): MY HUYEN TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 W LEGION RD
BRAWLEY CA
92227-7780
US

IV. Provider business mailing address

12865 MAIN ST STE 105
GARDEN GROVE CA
92840-8205
US

V. Phone/Fax

Practice location:
  • Phone: 760-351-4894
  • Fax:
Mailing address:
  • Phone: 800-768-1977
  • Fax: 800-768-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number206389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: