Healthcare Provider Details
I. General information
NPI: 1992994248
Provider Name (Legal Business Name): TRAN-GO MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2007
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1053 R ST
FRESNO CA
93721-1312
US
IV. Provider business mailing address
1053 R ST
FRESNO CA
93721-1312
US
V. Phone/Fax
- Phone: 559-233-3131
- Fax: 559-233-3133
- Phone: 559-233-3131
- Fax: 559-233-3133
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | A39065 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
PATRICK
HOWARD
TRAN
Title or Position: DIRECTOR
Credential: MD
Phone: 559-233-3131