Provider Demographics
NPI:1124643564
Name:TRAN, HEATHER VU (DPM)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:VU
Last Name:TRAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5248 GREAT MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6960
Mailing Address - Country:US
Mailing Address - Phone:949-295-8516
Mailing Address - Fax:
Practice Address - Street 1:5248 GREAT MEADOW DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6960
Practice Address - Country:US
Practice Address - Phone:949-295-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT17-2020213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist