Healthcare Provider Details

I. General information

NPI: 1023637055
Provider Name (Legal Business Name): KRISTI TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 09/13/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39400 PASEO PADRE PKWY EMERGENCY DEPARTMENT
FREMONT CA
94538
US

IV. Provider business mailing address

45354 RUTHERFORD TER
FREMONT CA
94539-6062
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-3000
  • Fax:
Mailing address:
  • Phone: 408-318-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA196146
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: