Healthcare Provider Details

I. General information

NPI: 1487645016
Provider Name (Legal Business Name): ROBERT T TRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 E CHAPMAN AVE STE C
ORANGE CA
92869-3990
US

IV. Provider business mailing address

4010 E CHAPMAN AVE STE C
ORANGE CA
92869-3990
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-6222
  • Fax: 714-532-3943
Mailing address:
  • Phone: 714-532-6222
  • Fax: 714-532-3943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13472
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA71300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: