Provider Demographics
NPI:1821076316
Name:TRAN, KHOI M (MD)
Entity Type:Individual
Prefix:
First Name:KHOI
Middle Name:M
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1640 NEWPORT BLVD
Mailing Address - Street 2:STE 350
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-7745
Mailing Address - Country:US
Mailing Address - Phone:949-386-5260
Mailing Address - Fax:949-515-0031
Practice Address - Street 1:1640 NEWPORT BLVD
Practice Address - Street 2:STE 350
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-7745
Practice Address - Country:US
Practice Address - Phone:949-386-5260
Practice Address - Fax:949-515-0031
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD22244207RG0100X
CAA54763207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR288183Medicaid
G58051Medicare UPIN
OR288183Medicaid