Provider Demographics
NPI:1164566311
Name:TRAN, DANA DOAN AI (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:DOAN AI
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 1:2141 N HARBOR BLVD STE 25000
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3830
Mailing Address - Country:US
Mailing Address - Phone:714-626-8669
Mailing Address - Fax:714-626-8692
Practice Address - Street 1:2141 N HARBOR BLVD STE 25000
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3830
Practice Address - Country:US
Practice Address - Phone:714-626-8669
Practice Address - Fax:714-626-8692
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80528207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A805280Medicaid
CAA71753OtherBS
CA00A805280OtherBS
CAA71753OtherBS