MEDICARE: PRISCILLA SUE 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
1	363LF0000X	Family Nurse Practitioner	RN218706	GA
2	363LF0000X	Family Nurse Practitioner	95007515	CA
3	363LF0000X	Family Nurse Practitioner	RN95142259	CA

General Provider Information

NPI Number	:	1942748330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA SUE TRAN

Provider Business Mailing Address
First Line	:	15500 SAND CANYON AVE STE 100
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-7708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15500 SAND CANYON AVE STE 100
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-7708
Country	:	US
Telephone Number	:	949-726-0600
Fax Number	:

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

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	03/29/2024

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Directions to “ PRISCILLA SUE TRAN ” Practice Location

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