Provider Demographics
NPI:1477631000
Name:TRAN, HUNG LUU (DC)
Entity Type:Individual
Prefix:DR
First Name:HUNG
Middle Name:LUU
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6480 WEATHERS PL
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3910
Mailing Address - Country:US
Mailing Address - Phone:858-646-0616
Mailing Address - Fax:858-646-0617
Practice Address - Street 1:6480 WEATHERS PL
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3910
Practice Address - Country:US
Practice Address - Phone:858-646-0616
Practice Address - Fax:858-646-0617
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGDC000510Medicaid
CAW16594AMedicare ID - Type Unspecified