Provider Demographics
NPI:1417044785
Name:TRAN, ANH C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:C
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 1:1714 N BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2812
Mailing Address - Country:US
Mailing Address - Phone:714-541-8883
Mailing Address - Fax:714-541-8882
Practice Address - Street 1:1714 N BUSH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2812
Practice Address - Country:US
Practice Address - Phone:714-541-8883
Practice Address - Fax:714-541-8882
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79019174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA77-0610717OtherTIN
CAH76596Medicare UPIN
CAW17158Medicare ID - Type Unspecified