Provider Demographics
NPI:1528021490
Name:TRAN, VU ANH
Entity Type:Individual
Prefix:
First Name:VU
Middle Name:ANH
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 KIERAN CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7400
Mailing Address - Country:US
Mailing Address - Phone:707-332-8561
Mailing Address - Fax:707-962-8210
Practice Address - Street 1:4710 HOEN AVE # B
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7887
Practice Address - Country:US
Practice Address - Phone:707-339-8299
Practice Address - Fax:707-962-8210
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79456207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ51167ZOtherGROUPONE
CAZZZ51167ZOtherGROUPONE
CAH76849Medicare UPIN
CA208365299Medicare Oscar/Certification