Healthcare Provider Details

I. General information

NPI: 1275448276
Provider Name (Legal Business Name): HENRY TRAN OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3858 W CARSON ST STE 100
TORRANCE CA
90503-6705
US

IV. Provider business mailing address

2017 W JEANETTE PL
LONG BEACH CA
90810-3010
US

V. Phone/Fax

Practice location:
  • Phone: 424-225-1481
  • Fax:
Mailing address:
  • Phone: 507-513-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number29367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: