Provider Demographics
NPI:1619219185
Name:TRAN, LINH KIM (DC)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:KIM
Last Name:TRAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15415 JEFFREY RD
Mailing Address - Street 2:#104
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4107
Mailing Address - Country:US
Mailing Address - Phone:949-654-5463
Mailing Address - Fax:949-654-5474
Practice Address - Street 1:15415 JEFFREY RD
Practice Address - Street 2:#104
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4107
Practice Address - Country:US
Practice Address - Phone:949-654-5463
Practice Address - Fax:949-654-5474
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15110111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor