Provider Demographics
NPI:1679892392
Name:TRAN, QUYEN ANH
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:ANH
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 NEWPORT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6943
Mailing Address - Country:US
Mailing Address - Phone:833-334-6393
Mailing Address - Fax:
Practice Address - Street 1:879 NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:833-334-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5745207Q00000X
CODR.0066763207Q00000X
NJ25MA11500600207Q00000X
IL036152209207Q00000X
NY306314207Q00000X
GA90647207Q00000X
MDD93623207Q00000X
MA290491207Q00000X
WAMD61077437207Q00000X
VA0101274362207Q00000X
DCMD210002011207Q00000X
PAMD477780207Q00000X
AZ64219207Q00000X
FLME152060207Q00000X
CAC159181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine