Healthcare Provider Details

I. General information

NPI: 1114710555
Provider Name (Legal Business Name): WYNN MEDICAL CENTER INTERNAL MEDICINE PASADENA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S FAIR OAKS AVE STE 203
PASADENA CA
91105-2536
US

IV. Provider business mailing address

301 S FAIR OAKS AVE STE 203
PASADENA CA
91105-2536
US

V. Phone/Fax

Practice location:
  • Phone: 626-356-4000
  • Fax:
Mailing address:
  • Phone: 626-356-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUYNH W TRAN
Title or Position: PRESIDEN/CEO
Credential: MD, FACP
Phone: 626-356-4000