Healthcare Provider Details

I. General information

NPI: 1356928147
Provider Name (Legal Business Name): LUCY NGOC BICH TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LUCY TRAN MD

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 16TH ST STE 307
SANTA MONICA CA
90404-1239
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-481-4242
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA193894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: