Provider Demographics
NPI:1962523613
Name:TRAN, ANNA PHUONG (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:PHUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:PHUONG-LY
Other - Middle Name:T
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10058 E SOUTH BEND DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-2540
Mailing Address - Country:US
Mailing Address - Phone:480-250-6326
Mailing Address - Fax:623-536-9288
Practice Address - Street 1:8811 N 51ST AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4949
Practice Address - Country:US
Practice Address - Phone:623-536-6788
Practice Address - Fax:623-536-9288
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ293342083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ126048Medicare PIN
AZZ133207Medicare UPIN
AZZ133040Medicare UPIN
AZZ120952Medicare PIN