MEDICARE: DR. GIANG TUNG 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
1	1223G0001X	General Practice Dentistry	30528	TX
2	122300000X	Dentist	100096	CA

General Provider Information

NPI Number	:	1093193989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIANG TUNG TRAN

Provider Business Mailing Address
First Line	:	11122 BIXLER CIR
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92840-2253
Country	:	US
Telephone Number	:	714-705-9452
Fax Number	:

Provider Business Practice Location Address
First Line	:	3698 S BRISTOL ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-7302
Country	:	US
Telephone Number	:	714-705-9452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	06/29/2016

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