Healthcare Provider Details
I. General information
NPI: 1720229099
Provider Name (Legal Business Name): MRS. NGOC N TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/17/2009
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 S MAIN ST SUITE 1100
ORANGE CA
92868-4507
US
IV. Provider business mailing address
500 S MAIN ST SUITE 1100
ORANGE CA
92868-4507
US
V. Phone/Fax
- Phone: 714-955-6572
- Fax: 714-543-4398
- Phone: 714-955-6572
- Fax: 714-543-4398
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: