Provider Demographics
NPI:1245767037
Name:TRAN, TAM K (MD)
Entity Type:Individual
Prefix:
First Name:TAM
Middle Name:K
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 1:7830 CLAIREMONT MESA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1632
Mailing Address - Country:US
Mailing Address - Phone:858-268-1111
Mailing Address - Fax:724-770-7947
Practice Address - Street 1:7830 CLAIREMONT MESA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1632
Practice Address - Country:US
Practice Address - Phone:858-268-1111
Practice Address - Fax:858-268-0761
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213262390200000X
CAA170139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program