Provider Demographics
NPI:1841216801
Name:TRAN, DU QUANG (MD)
Entity Type:Individual
Prefix:
First Name:DU
Middle Name:QUANG
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10090 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843
Mailing Address - Country:US
Mailing Address - Phone:714-590-1682
Mailing Address - Fax:714-590-1778
Practice Address - Street 1:10090 WESTMINSTER AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843
Practice Address - Country:US
Practice Address - Phone:714-590-1682
Practice Address - Fax:714-590-1778
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA51921208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A519210Medicaid
F62371Medicare UPIN
CA00A519210Medicaid