Healthcare Provider Details

I. General information

NPI: 1033679568
Provider Name (Legal Business Name): XUAN HOANG LINDA THI TRAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA THI TRAN NP

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 CHERRY ST STE 200
LOS ALAMITOS CA
90720-2473
US

IV. Provider business mailing address

10921 CHERRY ST STE 200
LOS ALAMITOS CA
90720-2473
US

V. Phone/Fax

Practice location:
  • Phone: 562-594-5996
  • Fax:
Mailing address:
  • Phone: 562-594-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95005959
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: