Provider Demographics
NPI:1063949972
Name:TRAN, VAN THANH (MD)
Entity type:Individual
Prefix:
First Name:VAN
Middle Name:THANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4442
Mailing Address - Country:US
Mailing Address - Phone:626-565-3288
Mailing Address - Fax:
Practice Address - Street 1:120 W HELLMAN AVE
Practice Address - Street 2:#303
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1209
Practice Address - Country:US
Practice Address - Phone:626-565-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA170843207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology