Provider Demographics
NPI:1609195981
Name:TRAN, JADE CONNIE (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:JADE
Middle Name:CONNIE
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD,MPH
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Mailing Address - Street 1:11234 ANDERSON ST STE 1617
Mailing Address - Street 2:LOMA LINDA UNIVERSITY HEALTH - INTERNATIONAL HEART INST
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-4207
Mailing Address - Fax:410-955-0897
Practice Address - Street 1:11234 ANDERSON ST STE 1617
Practice Address - Street 2:JOHNS HOPKINS HOSPITAL - TAUSSIG HEART CENTER
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4207
Practice Address - Fax:410-955-0897
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2017-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA112503208000000X, 207RC0000X, 2080P0202X, 207RH0005X
MDT8182282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No282NC2000XHospitalsGeneral Acute Care HospitalChildren
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA112503OtherCALIFORNIA STATE LICENSE