Provider Demographics
NPI:1114198843
Name:LOUIE, TRANG T (PA-C)
Entity Type:Individual
Prefix:
First Name:TRANG
Middle Name:T
Last Name:LOUIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40690 CALIFORNIA OAKS RD
Mailing Address - Street 2:#A
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5857
Mailing Address - Country:US
Mailing Address - Phone:951-677-0098
Mailing Address - Fax:951-677-2017
Practice Address - Street 1:40690 CALIFORNIA OAKS RD
Practice Address - Street 2:#A
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5857
Practice Address - Country:US
Practice Address - Phone:951-677-0098
Practice Address - Fax:951-677-2017
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16908363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant