Provider Demographics
NPI:1376570184
Name:TRANVAN, TU (MD)
Entity Type:Individual
Prefix:DR
First Name:TU
Middle Name:
Last Name:TRANVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TU
Other - Middle Name:
Other - Last Name:TRANVAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1402 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2009
Mailing Address - Country:US
Mailing Address - Phone:626-792-1149
Mailing Address - Fax:626-285-7698
Practice Address - Street 1:9143 VALLEY BLVD
Practice Address - Street 2:203
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1991
Practice Address - Country:US
Practice Address - Phone:626-285-7598
Practice Address - Fax:626-285-7698
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52994207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A529942Medicaid
CAA52994BMedicare ID - Type Unspecified