Healthcare Provider Details

I. General information

NPI: 1467466243
Provider Name (Legal Business Name): TU ANH TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 SATURN AVE SUITE 230
HUNTINGTON PARK CA
90255-4377
US

IV. Provider business mailing address

16660 PARAMOUNT BLVD SUITE 312
PARAMOUNT CA
90723-5433
US

V. Phone/Fax

Practice location:
  • Phone: 323-588-9748
  • Fax: 323-588-9749
Mailing address:
  • Phone: 562-529-8821
  • Fax: 562-529-8828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA53389
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA53389
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberA53389
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA53389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: