MEDICARE: DR. HUNG TRAN M.D.

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	2084P0800X	Psychiatry Physician	16732	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225010937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUNG TRAN M.D.

Provider Business Mailing Address
First Line	:	875 OAK ST SE
Second Line	:	STE 3070
City	:	SALEM
State	:	OR
Zip	:	97301-3975
Country	:	US
Telephone Number	:	503-585-7454
Fax Number	:	503-585-9254

Provider Business Practice Location Address
First Line	:	875 OAK ST SE
Second Line	:	STE 3070
City	:	SALEM
State	:	OR
Zip	:	97301-3975
Country	:	US
Telephone Number	:	503-585-7454
Fax Number	:	503-585-9254

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	09/03/2010

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