Healthcare Provider Details

I. General information

NPI: 1003828583
Provider Name (Legal Business Name): DAN B TRAN MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/18/2024
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 S MAIN ST STE 325
ORANGE CA
92868-3818
US

IV. Provider business mailing address

4300 LONG BEACH BLVD STE 400
LONG BEACH CA
90807-2008
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-1213
  • Fax: 714-771-7126
Mailing address:
  • Phone: 562-591-7700
  • Fax: 561-591-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG83738
License Number StateCA

VIII. Authorized Official

Name: MICHELE M STEPP
Title or Position: CONTRACTING
Credential:
Phone: 714-771-1213