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General NPI Number Information
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NPI Number | 1689794711
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Entity Type | Individual
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Provider Name | JENNIFER T.D. TRAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 445 MARINE VIEW AVE STE 300
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City | DEL MAR
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State | CA
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Zip | 92014-3926
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Country | US
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Telephone | 858-740-7087
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Fax | 858-997-2591
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Provider Business Mailing Address
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Address Line | PO BOX 90544
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City | SAN DIEGO
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State | CA
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Zip | 92169-2544
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Country | US
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Telephone | 858-646-3025
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Fax | 858-997-2591
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A 6643
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License Number State | CA
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