Provider Demographics
NPI:1891790523
Name:TRANDINH, CHUTUOC CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHUTUOC
Middle Name:CHRISTINE
Last Name:TRANDINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHUTUOC
Other - Middle Name:C
Other - Last Name:TRANDINH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2164
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97528-0270
Mailing Address - Country:US
Mailing Address - Phone:541-479-7791
Mailing Address - Fax:541-479-8515
Practice Address - Street 1:8600 NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-8978
Practice Address - Country:US
Practice Address - Phone:541-862-2836
Practice Address - Fax:541-862-2806
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR299508Medicaid
OR117164Medicare ID - Type Unspecified
OR299508Medicaid