Healthcare Provider Details
I. General information
NPI: 1437327723
Provider Name (Legal Business Name): CHAU QUYNH TRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 VALLEY STREET
DAYTON OH
45404-1815
US
IV. Provider business mailing address
824 WARRINGTON PL
DAYTON OH
45419-3646
US
V. Phone/Fax
- Phone: 937-641-3000
- Fax:
- Phone: 571-235-8455
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 57-013959 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: