Provider Demographics
NPI:1619248903
Name:TRAN, DILLON N (DO, FACOFP)
Entity Type:Individual
Prefix:DR
First Name:DILLON
Middle Name:N
Last Name:TRAN
Suffix:
Gender:M
Credentials:DO, FACOFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 BOLSA AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-5564
Mailing Address - Country:US
Mailing Address - Phone:714-897-3300
Mailing Address - Fax:
Practice Address - Street 1:9191 BOLSA AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5564
Practice Address - Country:US
Practice Address - Phone:714-897-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine