Provider Demographics
NPI:1598351033
Name:TRAN, TRISH
Entity Type:Individual
Prefix:
First Name:TRISH
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17595 HARVARD AVE STE C-790
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-8516
Mailing Address - Country:US
Mailing Address - Phone:949-864-6408
Mailing Address - Fax:
Practice Address - Street 1:17595 HARVARD AVE STE C-790
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-8516
Practice Address - Country:US
Practice Address - Phone:949-864-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant