Provider Demographics
NPI:1689363020
Name:TRAN, ALLEN (PA-S)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 S 400 W # B434
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-4801
Mailing Address - Country:US
Mailing Address - Phone:801-889-0833
Mailing Address - Fax:
Practice Address - Street 1:824 S 400 W # B434
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-4801
Practice Address - Country:US
Practice Address - Phone:801-889-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program