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General NPI Number Information
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NPI Number | 1235768920
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Entity Type | Individual
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Provider Name | TRACY TRAN NP
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Gender | Female
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 625 E VALLEY BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3591
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Country | US
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Telephone | 626-572-4658
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 WINSTON DR
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City | EL MONTE
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State | CA
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Zip | 91731-2046
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Country | US
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Telephone | 626-380-5568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95014352
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License Number State | CA
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