Provider Demographics
NPI:1578589115
Name:TRAN, SANG D (MD)
Entity Type:Individual
Prefix:
First Name:SANG
Middle Name:D
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13768 ROSWELL AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1402
Mailing Address - Country:US
Mailing Address - Phone:909-591-8200
Mailing Address - Fax:866-701-9305
Practice Address - Street 1:13768 ROSWELL AVE STE 118
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1402
Practice Address - Country:US
Practice Address - Phone:909-591-8200
Practice Address - Fax:866-701-9305
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYR1038207Q00000X
NV12502207Q00000X
CAC167687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV12502OtherNEVADA MEDICAL LICENSE
000000531714OtherBCBS PROVIDER NUMBER
KY40225OtherMEDICAL LICENSE
KY64113806Medicaid
KY64113806Medicaid
I43419Medicare UPIN
BT9475117OtherDEA
KYP00356627Medicare PIN
0935342Medicare PIN