Provider Demographics
NPI:1679645204
Name:TRIEU T TRAN, MD. INC.
Entity Type:Organization
Organization Name:TRIEU T TRAN, MD. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC
Authorized Official - Prefix:DR
Authorized Official - First Name:TRIEU
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-893-6008
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-0457
Mailing Address - Country:US
Mailing Address - Phone:909-971-9334
Mailing Address - Fax:909-971-9654
Practice Address - Street 1:15191 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6203
Practice Address - Country:US
Practice Address - Phone:714-893-6008
Practice Address - Fax:714-893-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19470Medicare PIN
CA6228660001Medicare NSC