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NPI Code Detail

MEDICARE: THOMAS THANH TRAN MD

MEDICARE: THOMAS THANH 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
1208M00000XHospitalist PhysicianA85242CA
2207R00000XInternal Medicine PhysicianA85242CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100A852420OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1710972997
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS THANH TRAN MD
Provider Business Mailing Address
First Line : PO BOX 77790
Second Line :
City : CORONA
State : CA
Zip : 92877-0126
Country : US
Telephone Number : 951-278-5590
Fax Number :
Provider Business Practice Location Address
First Line : 800 S MAIN ST
Second Line :
City : CORONA
State : CA
Zip : 92882-3420
Country : US
Telephone Number : 951-278-5590
Fax Number : 951-272-9924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 12/08/2021

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