Provider Demographics
NPI:1508408543
Name:TRAN, HUNG (PA)
Entity Type:Individual
Prefix:
First Name:HUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 RANGER LOOP
Mailing Address - Street 2:BLDG 184
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-5072
Mailing Address - Country:US
Mailing Address - Phone:630-346-4996
Mailing Address - Fax:
Practice Address - Street 1:1897 RANGER LOOP
Practice Address - Street 2:BLDG 184
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-5072
Practice Address - Country:US
Practice Address - Phone:630-346-4996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
1044041OtherNOAA