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NPI Code Detail

MEDICARE: THERESA THANH THUY TRAN

MEDICARE: THERESA THANH THUY TRAN
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1053919142
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA THANH THUY TRAN
Provider Business Mailing Address
First Line : 1 PARK PLZ STE 600
Second Line :
City : IRVINE
State : CA
Zip : 92614-5987
Country : US
Telephone Number : 949-515-7300
Fax Number :
Provider Business Practice Location Address
First Line : 1 PARK PLZ STE 600
Second Line :
City : IRVINE
State : CA
Zip : 92614-5987
Country : US
Telephone Number : 949-515-7300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 06/28/2021

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Directions to “ THERESA THANH THUY TRAN ” Practice Location

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