MEDICARE: DR. CHI TRAN LAW D.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	1223G0001X	General Practice Dentistry	51770	CA

General Provider Information

NPI Number	:	1336295542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHI TRAN LAW D.M.D.

Provider Business Mailing Address
First Line	:	2011 WESTCLIFF DR STE 10
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5508
Country	:	US
Telephone Number	:	949-646-5411
Fax Number	:	949-646-5391

Provider Business Practice Location Address
First Line	:	2011 WESTCLIFF DR STE 10
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-5508
Country	:	US
Telephone Number	:	949-646-5411
Fax Number	:	949-646-5391

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

Provider Enumeration Date	:	01/28/2007
Last Update Date	:	04/10/2008

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