Healthcare Provider Details

I. General information

NPI: 1457653545
Provider Name (Legal Business Name): MR. NGUYEN TRAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FASHION LN STE 112
TUSTIN CA
92780-3362
US

IV. Provider business mailing address

325 W HOSPITALITY LN STE 210
SAN BERNARDINO CA
92408-3211
US

V. Phone/Fax

Practice location:
  • Phone: 714-884-3400
  • Fax: 714-884-3882
Mailing address:
  • Phone: 951-268-2535
  • Fax: 951-268-9127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA7530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: