Provider Demographics
NPI:1043292410
Name:TRAN, LOAN NGOC (MD)
Entity Type:Individual
Prefix:
First Name:LOAN
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 TREAT BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:
Practice Address - Street 1:400 TAYLOR BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2114
Practice Address - Country:US
Practice Address - Phone:925-435-1105
Practice Address - Fax:925-677-5011
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG757432085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G757430OtherBLUE SHIELD
CA00G757430Medicaid
CA00G757430Medicaid
CA00G757431Medicare PIN
CA00G757430OtherBLUE SHIELD