Healthcare Provider Details

I. General information

NPI: 1033049580
Provider Name (Legal Business Name): MINH QUANG THUAN TRAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE STREET
BOSTON MA
02135
US

IV. Provider business mailing address

736 CAMBRIDGE STREET
BOSTON MA
02135
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number3020471
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: