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General NPI Number Information
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NPI Number | 1487061107
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Entity Type | Individual
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Provider Name | MICHAEL ADAM TRAN DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 16700 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-3243
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Country | US
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Telephone | 310-921-8409
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Fax |
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Provider Business Mailing Address
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Address Line | 12920 RUNWAY RD UNIT 320
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City | PLAYA VISTA
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State | CA
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Zip | 90094-2394
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Country | US
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Telephone | 949-702-1133
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 63617
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License Number State | CA
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