Provider Demographics
NPI:1780635169
Name:TRAN, MICHAEL Q (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:Q
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-554-9999
Mailing Address - Fax:858-554-9136
Practice Address - Street 1:10710 N TORREY PINES RD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1035
Practice Address - Country:US
Practice Address - Phone:858-554-9999
Practice Address - Fax:858-554-9136
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG80738208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G807380Medicaid
F613OtherCHAMPUS
CA00G807380Medicaid
CA00G807380Medicaid
WG80738AMedicare PIN