Healthcare Provider Details

I. General information

NPI: 1588008064
Provider Name (Legal Business Name): DOROTHY TRAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2013
Last Update Date: 04/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W SANTA ANA BLVD SUITE 100
SANTA ANA CA
92701-4134
US

IV. Provider business mailing address

209 ZION WAY
SANTA ANA CA
92703-4148
US

V. Phone/Fax

Practice location:
  • Phone: 714-347-0343
  • Fax:
Mailing address:
  • Phone: 714-564-0488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN458932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: