Provider Demographics
NPI:1588826150
Name:QUY, HUONG TRAN (DO)
Entity Type:Individual
Prefix:DR
First Name:HUONG
Middle Name:TRAN
Last Name:QUY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9559 BOLSA AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5986
Mailing Address - Country:US
Mailing Address - Phone:714-531-5754
Mailing Address - Fax:714-531-5824
Practice Address - Street 1:9559 BOLSA AVE
Practice Address - Street 2:SUITE D
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5986
Practice Address - Country:US
Practice Address - Phone:714-531-5754
Practice Address - Fax:714-531-5824
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11084207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A11084OtherMEDICAL LICENSE
CA20A11084OtherMEDICAL LICENSE