Provider Demographics
NPI:1891864203
Name:TRAN, PETER (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3-3420 KUHIO HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1042
Mailing Address - Country:US
Mailing Address - Phone:808-245-1505
Mailing Address - Fax:
Practice Address - Street 1:3-3420 KUHIO HWY
Practice Address - Street 2:SUITE B
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1042
Practice Address - Country:US
Practice Address - Phone:808-245-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS 1625208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology