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NPI Code Detail

MEDICARE: ANNA DIEM TRAN

MEDICARE:   ANNA DIEM TRAN
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1598041790
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA DIEM TRAN
Provider Business Mailing Address
First Line : 4638 SE 29TH ST
Second Line :
City : DEL CITY
State : OK
Zip : 73115-3429
Country : US
Telephone Number : 405-595-9579
Fax Number :
Provider Business Practice Location Address
First Line : 4638 SE 29TH ST
Second Line :
City : DEL CITY
State : OK
Zip : 73115-3429
Country : US
Telephone Number : 405-595-9579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2011
Last Update Date : 11/01/2011

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Directions to “ ANNA DIEM TRAN ” Practice Location

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