Provider Demographics
NPI:1497885859
Name:TRAN, PAUL L (DMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:TRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2489 S BALDWIN AVE
Mailing Address - Street 2:UNIT 1
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-8323
Mailing Address - Country:US
Mailing Address - Phone:626-286-2475
Mailing Address - Fax:626-286-8752
Practice Address - Street 1:1217 BUENA VISTA
Practice Address - Street 2:STE 202
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010
Practice Address - Country:US
Practice Address - Phone:626-357-2254
Practice Address - Fax:626-358-0305
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice