Provider Demographics
NPI:1225210438
Name:TRAN, MICHELL RUELOS
Entity Type:Individual
Prefix:MRS
First Name:MICHELL
Middle Name:RUELOS
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MICHELL
Other - Middle Name:LINGATONG
Other - Last Name:RUELOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5417 SOHO VIEW TER
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-2391
Mailing Address - Country:US
Mailing Address - Phone:619-623-9414
Mailing Address - Fax:
Practice Address - Street 1:5417 SOHO VIEW TER
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2391
Practice Address - Country:US
Practice Address - Phone:619-623-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker