Healthcare Provider Details

I. General information

NPI: 1548269087
Provider Name (Legal Business Name): JEAN G. TRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10402 WESTMINSTER AVE SUITE 100C
GARDEN GROVE CA
92843
US

IV. Provider business mailing address

13031 KERRY ST
GARDEN GROVE CA
92844-1638
US

V. Phone/Fax

Practice location:
  • Phone: 714-638-1358
  • Fax: 714-741-0693
Mailing address:
  • Phone: 657-233-0344
  • Fax: 872-241-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number022786
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC175369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: