Provider Demographics
NPI:1891720884
Name:TRANI, SERGIO IBANEZ JR (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:IBANEZ
Last Name:TRANI
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:15955 PARAMOUNT BLVD
Mailing Address - Street 2:UNIT A
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5113
Mailing Address - Country:US
Mailing Address - Phone:562-531-9806
Mailing Address - Fax:562-531-1394
Practice Address - Street 1:15955 PARAMOUNT BLVD
Practice Address - Street 2:UNIT A
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5113
Practice Address - Country:US
Practice Address - Phone:562-531-9806
Practice Address - Fax:562-531-1394
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAA48853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A488530Medicaid
CA00A488530Medicaid
CAF95687Medicare UPIN