MEDICARE: CHAN-TRAN P DANG D.O.

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	208000000X	Pediatrics Physician	DO1626	NV

General Provider Information

NPI Number	:	1578725131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAN-TRAN P DANG D.O.

Provider Business Mailing Address
First Line	:	3131 LA CANADA ST
Second Line	:	#244
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2578
Country	:	US
Telephone Number	:	702-697-0016
Fax Number	:	702-691-9984

Provider Business Practice Location Address
First Line	:	3131 LA CANADA ST
Second Line	:	#244
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2578
Country	:	US
Telephone Number	:	702-697-0016
Fax Number	:	702-691-9984

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	11/29/2021

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Directions to “ CHAN-TRAN P DANG D.O.” Practice Location

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