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General NPI Number Information
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NPI Number | 1013277763
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Entity Type | Organization
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Legal Business Name | NICHOLAS THANH QUANG TRAN MD A
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 15651 BROOKHURST ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-7556
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Country | US
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Telephone | 714-531-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 15651 BROOKHURST ST
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City | WESTMINSTER
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State | CA
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Zip | 92683-7556
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Country | US
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Telephone | 714-531-6969
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICHOLAS TRAN
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Credential |
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Telephone | 714-531-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A67914
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License Number State | CA
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