Healthcare Provider Details

I. General information

NPI: 1013653773
Provider Name (Legal Business Name): NGOC-VAN THI TRAN-VALENCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NGOC-VAN THI TRAN MD

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 05/30/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE 4400 V STREET, SUITE 1107
SACRAMENTO CA
95817
US

IV. Provider business mailing address

DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE 4400 V STREET, SUITE 1107
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-0764
  • Fax: 916-734-0299
Mailing address:
  • Phone: 916-734-0764
  • Fax: 916-734-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: