Provider Demographics
NPI:1790364123
Name:TRAN, CHRISTIE AIVY (DO)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:AIVY
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:15000 KENSINGTON PARK DR STE 370
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-1835
Mailing Address - Country:US
Mailing Address - Phone:949-829-5500
Mailing Address - Fax:
Practice Address - Street 1:15000 KENSINGTON PARK DR STE 370
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-1835
Practice Address - Country:US
Practice Address - Phone:949-829-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A23129207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology