Healthcare Provider Details
I. General information
NPI: 1245144542
Provider Name (Legal Business Name): 3TTT A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11420 WARNER AVE
FOUNTAIN VALLEY CA
92708-2529
US
IV. Provider business mailing address
11420 WARNER AVE
FOUNTAIN VALLEY CA
92708-2529
US
V. Phone/Fax
- Phone: 858-230-4505
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
RICHARD
TUNG
TRAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 858-230-4505