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General NPI Number Information
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NPI Number | 1396316329
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Entity Type | Organization
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Legal Business Name | DIGESTIVE & LIVER CENTER CORP
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 11100 WARNER AVE STE 252
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-7511
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Country | US
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Telephone | 714-867-4457
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Fax |
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Provider Business Mailing Address
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Address Line | 519 S SONYA ST
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City | ANAHEIM
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State | CA
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Zip | 92802-1339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GASTROENTEROLOGIST
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Name | DR. KY-DIEU TRAN
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Credential | MD
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Telephone | 714-867-4457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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