Provider Demographics
NPI:1003900366
Name:TRAM, HIEU N (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEU N
Middle Name:
Last Name:TRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60426
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602
Mailing Address - Country:US
Mailing Address - Phone:714-775-3060
Mailing Address - Fax:714-531-0959
Practice Address - Street 1:15355 BROOKHURST STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7077
Practice Address - Country:US
Practice Address - Phone:714-775-3060
Practice Address - Fax:714-531-0959
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000G80793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG 80793OtherMEDICAL LICENSE
CA00G807930702Medicaid
CA00G807930702Medicaid
CA00G807930702Medicaid
CAWG80793DMedicare PIN
CAWG80793EMedicare PIN