Healthcare Provider Details

I. General information

NPI: 1467470823
Provider Name (Legal Business Name): NGOC-MAI THI TRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15057 GOLDENWEST ST
HUNTINGTON BEACH CA
92647-2710
US

IV. Provider business mailing address

15057 GOLDENWEST ST
HUNTINGTON BEACH CA
92647-2710
US

V. Phone/Fax

Practice location:
  • Phone: 562-774-1901
  • Fax:
Mailing address:
  • Phone: 323-415-6100
  • Fax: 323-415-6400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA870565
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: