Healthcare Provider Details

I. General information

NPI: 1487039640
Provider Name (Legal Business Name): MIKE QUOC TRAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HUNG TRAN MD

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 S MAIN ST STE 120
AKRON OH
44311-1064
US

IV. Provider business mailing address

PO BOX 512185
LOS ANGELES CA
90051-0185
US

V. Phone/Fax

Practice location:
  • Phone: 330-334-7800
  • Fax: 330-334-3252
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA196882
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number264995
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35.152955
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: