Provider Demographics
NPI:1619133659
Name:TRAN, HANG T (DO)
Entity Type:Individual
Prefix:
First Name:HANG
Middle Name:T
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W 5TH ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-8401
Mailing Address - Country:US
Mailing Address - Phone:512-789-5989
Mailing Address - Fax:
Practice Address - Street 1:1145 W REDONDO BEACH BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-3528
Practice Address - Country:US
Practice Address - Phone:310-538-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11793207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A11793OtherMEDICAL LICENSE