Provider Demographics
NPI:1386263317
Name:TRAN, BENJAMIN ALFRED (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ALFRED
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:625 S FAIR OAKS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2651
Mailing Address - Country:US
Mailing Address - Phone:626-793-7790
Mailing Address - Fax:626-793-9018
Practice Address - Street 1:625 S FAIR OAKS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2651
Practice Address - Country:US
Practice Address - Phone:626-793-7790
Practice Address - Fax:626-793-9018
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA195888207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology