MEDICARE: DR. KIET THE TRAN MD

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	207R00000X	Internal Medicine Physician	A43094	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A43094	OTHER	CA	STATE MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285636209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIET THE TRAN MD

Provider Business Mailing Address
First Line	:	815 W CESAR E CHAVEZ AVE
Second Line	:	SUITE 201
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-6602
Country	:	US
Telephone Number	:	213-617-8246
Fax Number	:	213-617-2363

Provider Business Practice Location Address
First Line	:	815 W CESAR E CHAVEZ AVE
Second Line	:	SUITE 201
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-6602
Country	:	US
Telephone Number	:	213-617-8246
Fax Number	:	213-617-2363

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/22/2008

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Directions to “ DR. KIET THE TRAN MD” Practice Location

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