Provider Demographics
NPI:1134319429
Name:TRAN, TANYA VAN (DO)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:VAN
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:225 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4212
Mailing Address - Country:US
Mailing Address - Phone:760-291-6700
Mailing Address - Fax:760-737-3430
Practice Address - Street 1:31537 RANCHO PUEBLO RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4841
Practice Address - Country:US
Practice Address - Phone:951-303-2277
Practice Address - Fax:951-303-6432
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9876207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine