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NPI Code Detail

MEDICARE: KIM NGAN NGOC TRAN DO

MEDICARE: KIM NGAN NGOC TRAN DO
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
1207Q00000XFamily Medicine Physician20A22930CA
2207Q00000XFamily Medicine Physician302581NY

General Provider Information

NPI Number : 1518491836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM NGAN NGOC TRAN DO
Provider Business Mailing Address
First Line : 253 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-1606
Country : US
Telephone Number : 909-860-1144
Fax Number :
Provider Business Practice Location Address
First Line : 253 S DIAMOND BAR BLVD
Second Line :
City : DIAMOND BAR
State : CA
Zip : 91765-1606
Country : US
Telephone Number : 909-860-1144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2017
Last Update Date : 09/25/2024

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Directions to “ KIM NGAN NGOC TRAN DO” Practice Location

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