Provider Demographics
NPI:1235465311
Name:TRAN, VIET (MD)
Entity Type:Individual
Prefix:DR
First Name:VIET
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S ALMA SCHOOL RD STE 310
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2812
Mailing Address - Country:US
Mailing Address - Phone:480-733-7305
Mailing Address - Fax:480-733-7306
Practice Address - Street 1:1125 S ALMA SCHOOL RD STE 310
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-2812
Practice Address - Country:US
Practice Address - Phone:480-733-7305
Practice Address - Fax:480-733-7306
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ59074207R00000X, 207RC0000X, 207RC0001X
TXBP1-0034534207R00000X
TXP1829207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ237031OtherMEDICARE PTAN
TX338331702Medicaid
TX344811YMAFOtherMEDICARE
AZ579889Medicaid
TX75-2616977-123OtherTRICARE
TXP01878866OtherMEDICARE RAIL ROAD
AZZ235578OtherMEDICARE PTAN