Healthcare Provider Details

I. General information

NPI: 1871223016
Provider Name (Legal Business Name): HOANG TRAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12425 LEWIS ST STE 101
GARDEN GROVE CA
92840-4654
US

IV. Provider business mailing address

13362 CHESTNUT ST
WESTMINSTER CA
92683-2606
US

V. Phone/Fax

Practice location:
  • Phone: 714-260-3350
  • Fax:
Mailing address:
  • Phone: 714-260-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. HOANG NGOC TRAN
Title or Position: SPEECH THERAPIST
Credential: MS
Phone: 714-260-3350