MEDICARE: WYNN MEDICAL CENTER

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	207N00000X	Dermatology Physician	A137091	CA
2	207R00000X	Internal Medicine Physician	A137091	CA
3	207RR0500X	Rheumatology Physician	A137091	CA
4	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1801300298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WYNN MEDICAL CENTER

Provider Business Mailing Address
First Line	:	9126 VALLEY BLVD STE B
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-1987
Country	:	US
Telephone Number	:	626-573-9003
Fax Number	:

Provider Business Practice Location Address
First Line	:	9126 VALLEY BLVD STE B
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-1987
Country	:	US
Telephone Number	:	626-573-9003
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. HUYNH W TRAN
Credential	:	MD, FACP
Telephone Number	:	626-573-9003

Provider Enumeration Date	:	11/22/2017
Last Update Date	:	05/28/2025

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Directions to “WYNN MEDICAL CENTER ” Practice Location

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