Healthcare Provider Details

I. General information

NPI: 1295966489
Provider Name (Legal Business Name): THU MICHELLE TRAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THU TRAN

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C240 MEDICAL SCIENCE I UCI INFUSION CENTER
IRVINE CA
92697
US

IV. Provider business mailing address

1 MEDICAL PLAZA DRIVE, RM. 1618 GOTTSCHALK MEDICAL PLAZA
IRVINE CA
92697
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-8334
  • Fax:
Mailing address:
  • Phone: 949-824-8334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP18981
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP18981
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: