Healthcare Provider Details

I. General information

NPI: 1255733465
Provider Name (Legal Business Name): SON T TRAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 PAULARINO AVE STE 100
COSTA MESA CA
92626-6917
US

IV. Provider business mailing address

PO BOX 3129
TORRANCE CA
90510-3129
US

V. Phone/Fax

Practice location:
  • Phone: 714-850-6430
  • Fax: 714-708-3729
Mailing address:
  • Phone: 310-792-3914
  • Fax: 855-898-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG70556
License Number StateCA

VIII. Authorized Official

Name: SON T TRAN
Title or Position: PRESIDENT
Credential: MD
Phone: 310-792-3914