MEDICARE: ROGER 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	332900000X	Non-Pharmacy Dispensing Site	A85461	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5616517	OTHER		OTHER ID NUMBER
2	5616517	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1780744755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGER TRAN MD

Provider Business Mailing Address
First Line	:	23521 PASEO DE VALENCIA
Second Line	:	SUITE 311
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3144
Country	:	US
Telephone Number	:	949-305-2660
Fax Number	:	949-305-2036

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA
Second Line	:	SUITE 311
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3144
Country	:	US
Telephone Number	:	949-305-2660
Fax Number	:	949-305-2036

Authorized Official
Title or Position	:	OWNER AND PHYSICIAN
Name	:	ROGER TRAN
Credential	:	MD
Telephone Number	:	949-305-2660

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	04/12/2010

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Directions to “ROGER TRAN MD ” Practice Location

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