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General NPI Number Information
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NPI Number | 1619178399
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Entity Type | Individual
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Provider Name | MAI TRAN FNP
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 7761 GARDEN GROVE BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92841-4200
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Country | US
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Telephone | 714-898-8888
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Fax | 714-898-8888
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Provider Business Mailing Address
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Address Line | 21885 HEATHERIDGE DR
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City | YORBA LINDA
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State | CA
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Zip | 92887-2665
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Country | US
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Telephone | 714-623-2102
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP 17142
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License Number State | CA
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