Provider Demographics
NPI:1598227134
Name:TRAN, TRUNG
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CHARLIE
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1334 S GARRETT ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-4818
Mailing Address - Country:US
Mailing Address - Phone:714-383-5142
Mailing Address - Fax:
Practice Address - Street 1:16575 BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2337
Practice Address - Country:US
Practice Address - Phone:657-247-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7497237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist