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General NPI Number Information
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NPI Number | 1538696778
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Entity Type | Individual
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Provider Name | DERRICK TRAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1400 REYNOLDS AVE STE 110
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City | IRVINE
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State | CA
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Zip | 92614-5562
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Country | US
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Telephone | 949-387-4724
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 REYNOLDS AVE STE 200
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City | IRVINE
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State | CA
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Zip | 92614-5563
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Country | US
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Telephone | 949-387-4724
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Fax | 949-209-0407
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME161812
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 33110
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | A190232
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License Number State | CA
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