Healthcare Provider Details

I. General information

NPI: 1154562148
Provider Name (Legal Business Name): QUYNH-ANH TRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: QUYNH-ANH NGUYEN M.D.

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 W JUDGE PEREZ DR
CHALMETTE LA
70043-1612
US

IV. Provider business mailing address

4504 KENT AVE
METAIRIE LA
70006-2064
US

V. Phone/Fax

Practice location:
  • Phone: 504-279-5547
  • Fax:
Mailing address:
  • Phone: 504-473-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.205010
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: