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General NPI Number Information
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NPI Number | 1801821426
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Entity Type | Organization
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Legal Business Name | CHUTUOC C. TRANDINH, M.D., L.L.C.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 124 NW MIDLAND AVE SUITE 109
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City | GRANTS PASS
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State | OR
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Zip | 97526-1269
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Country | US
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Telephone | 541-479-7791
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Fax | 541-479-8515
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Provider Business Mailing Address
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Address Line | PO BOX 2164
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City | GRANTS PASS
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State | OR
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Zip | 97528-0270
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Country | US
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Telephone | 541-479-7791
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Fax | 541-479-8515
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ROBYN L FUGETT
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Credential |
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Telephone | 541-479-7791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD24775
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License Number State | OR
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