Provider Demographics
NPI:1841985256
Name:TRAN, ALAN ANH TUYEN
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:ANH TUYEN
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 S GERTRUDA AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-4246
Mailing Address - Country:US
Mailing Address - Phone:310-465-5396
Mailing Address - Fax:
Practice Address - Street 1:2850 ARTESIA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3413
Practice Address - Country:US
Practice Address - Phone:310-371-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303934225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist