Healthcare Provider Details

I. General information

NPI: 1508277872
Provider Name (Legal Business Name): DZUNG TRAN MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 12/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6960 S CIMARRON RD STE 100
LAS VEGAS NV
89113-2182
US

IV. Provider business mailing address

PO BOX 400565
LAS VEGAS NV
89140-0565
US

V. Phone/Fax

Practice location:
  • Phone: 702-876-0186
  • Fax: 702-876-0608
Mailing address:
  • Phone: 702-876-0186
  • Fax: 702-876-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DZUNG V TRAN
Title or Position: PRESIDENT
Credential: MD
Phone: 702-876-0186