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NPI Code Detail

MEDICARE: VAN TRAN NP

MEDICARE: VAN TRAN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner95012043CA

General Provider Information

NPI Number : 1043867062
Entity Type Code : Individual
Provider Name (Legal Business Name) : VAN TRAN NP
Provider Business Mailing Address
First Line : 801 S CHEVY CHASE DR STE 250
Second Line :
City : GLENDALE
State : CA
Zip : 91205-4433
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 801 S CHEVY CHASE DR STE 250
Second Line :
City : GLENDALE
State : CA
Zip : 91205-4433
Country : US
Telephone Number : 818-265-2264
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2019
Last Update Date : 08/26/2019

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Directions to “ VAN TRAN NP” Practice Location

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