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General NPI Number Information
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NPI Number | 1114287083
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Entity Type | Organization
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Legal Business Name | QUANG TRUC TRAN, MD, PC
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 7297 LEE HWY STE E
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1707
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Country | US
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Telephone | 703-538-6248
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Fax | 703-538-6403
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Provider Business Mailing Address
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Address Line | 7297 LEE HWY STE E
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1707
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Country | US
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Telephone | 703-538-6248
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Fax | 703-538-6403
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. QUANG TRUC TRAN
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Credential | M.D.
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Telephone | 703-538-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 00101041832
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License Number State | VA
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