Provider Demographics
NPI:1225010937
Name:TRAN, HUNG (MD)
Entity type:Individual
Prefix:DR
First Name:HUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HUNG
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:STE 3070
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-585-7454
Mailing Address - Fax:503-585-9254
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:STE 3070
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-585-7454
Practice Address - Fax:503-585-9254
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR167322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR055488Medicaid
0000BKGBLMedicare ID - Type Unspecified
E77107Medicare UPIN