Healthcare Provider Details

I. General information

NPI: 1467037358
Provider Name (Legal Business Name): ANTHONY TRAN RCP, RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 ATLANTIC AVE STE 616
LONG BEACH CA
90813-3411
US

IV. Provider business mailing address

16724 CRENSHAW BLVD # 24
TORRANCE CA
90504-2139
US

V. Phone/Fax

Practice location:
  • Phone: 626-698-8613
  • Fax:
Mailing address:
  • Phone: 714-719-3605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number42363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: