MEDICARE: DR. TRUNG QUY 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	207Q00000X	Family Medicine Physician	A41268	CA

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	:	1538232335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRUNG QUY TRAN MD

Provider Business Mailing Address
First Line	:	4139 UNIVERSITY AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105
Country	:	US
Telephone Number	:	619-281-3443
Fax Number	:	619-281-7193

Provider Business Practice Location Address
First Line	:	4139 UNIVERSITY AVENUE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105
Country	:	US
Telephone Number	:	619-281-3443
Fax Number	:	619-281-7193

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	04/26/2026

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