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General NPI Number Information
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NPI Number | 1699129916
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Entity Type | Organization
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Legal Business Name | TIMOTHY THIEN TRAN MD INC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 12302 GARDEN GROVE BLVD STE 7
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1833
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Country | US
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Telephone | 714-823-0361
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Fax | 951-680-1606
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Provider Business Mailing Address
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Address Line | 12302 GARDEN GROVE BLVD STE 7
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City | GARDEN GROVE
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State | CA
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Zip | 92843-1833
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Country | US
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Telephone | 714-823-0361
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Fax | 951-680-1606
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY THIEN TRAN
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Credential | MD
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Telephone | 714-823-0361
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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 | A123698
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License Number State | CA
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