Healthcare Provider Details

I. General information

NPI: 1528624913
Provider Name (Legal Business Name): KHANG TRAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2019
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

757 WESTWOOD PLZ PEDIATRIC GASTROENTEROLOGY
LOS ANGELES CA
90095-7419
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2000
  • Fax:
Mailing address:
  • Phone: 310-825-6481
  • Fax: 310-825-9832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberDO.OP.70129319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: