Healthcare Provider Details

I. General information

NPI: 1780703082
Provider Name (Legal Business Name): MR. HANG THANH TRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10362 BOLSA AVE
WESTMINSTER CA
92683-6763
US

IV. Provider business mailing address

8211 BRIARWOOD ST
STANTON CA
90680-3811
US

V. Phone/Fax

Practice location:
  • Phone: 714-531-2091
  • Fax: 714-531-1403
Mailing address:
  • Phone: 714-891-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number588706
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: