Provider Demographics
NPI:1275545352
Name:TRAN, DZUNG VU (MD)
Entity Type:Individual
Prefix:
First Name:DZUNG
Middle Name:VU
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 400565
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0565
Mailing Address - Country:US
Mailing Address - Phone:702-876-0186
Mailing Address - Fax:702-876-0608
Practice Address - Street 1:6960 S CIMARRON RD
Practice Address - Street 2:STE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2182
Practice Address - Country:US
Practice Address - Phone:702-876-0186
Practice Address - Fax:702-876-0608
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV7854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019746Medicaid
NV7854OtherSTATE LICENSE
NVG32835Medicare UPIN
NVMD7854Medicare ID - Type Unspecified