Provider Demographics
NPI:1770841652
Name:TRAN, TINO LAN (MD)
Entity Type:Individual
Prefix:
First Name:TINO
Middle Name:LAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1350 EDGMONT AVE STE 1500
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3962
Mailing Address - Country:US
Mailing Address - Phone:610-619-8290
Mailing Address - Fax:610-619-8288
Practice Address - Street 1:1 MEDICAL CENTER BLVD STE 334
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-872-7660
Practice Address - Fax:610-876-2628
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2019-03-28
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Provider Licenses
StateLicense IDTaxonomies
PAMD458887207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103153605Medicaid