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General NPI Number Information
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NPI Number | 1306002878
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Entity Type | Individual
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Provider Name | AUTUMN THU TRAN
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Gender | Female
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 1000 W LA VETA AVE
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City | ORANGE
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State | CA
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Zip | 92868-4304
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Country | US
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Telephone | 714-734-2694
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Fax |
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Provider Business Mailing Address
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Address Line | 322 W ALPINE AVE
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City | SANTA ANA
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State | CA
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Zip | 92707-4309
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Country | US
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Telephone | 714-717-3638
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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 | 95024196
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License Number State | CA
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