Healthcare Provider Details

I. General information

NPI: 1306469838
Provider Name (Legal Business Name): SAMANTHA TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17305 VON KARMAN AVE STE 107
IRVINE CA
92614-0903
US

IV. Provider business mailing address

4000 HOLLYWOOD BLVD STE 215S
HOLLYWOOD FL
33021-1227
US

V. Phone/Fax

Practice location:
  • Phone: 949-679-9994
  • Fax: 949-679-9933
Mailing address:
  • Phone: 202-963-6487
  • Fax: 206-309-8389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA193541
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: