Provider Demographics
NPI:1427013986
Name:TRAN, KHOA D (MD)
Entity Type:Individual
Prefix:DR
First Name:KHOA
Middle Name:D
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 1:153 E 13TH ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16503-1035
Mailing Address - Country:US
Mailing Address - Phone:814-452-5530
Mailing Address - Fax:814-452-5419
Practice Address - Street 1:232 W 25TH ST # 3R
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16544-6929
Practice Address - Country:US
Practice Address - Phone:814-452-5530
Practice Address - Fax:814-452-5419
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0797292084P0800X
PAMD4220412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2317139Medicaid
OH7323531Medicare PIN
OH4202762Medicare PIN
OHP00412077Medicare PIN
OHP00138752Medicare PIN