Provider Demographics
NPI:1962665786
Name:TRAN, DIANE D (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:D
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DUC
Other - Middle Name:THI PHUC
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11234 ANDERSON ST # 1617
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-4754
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON STRESS
Practice Address - Street 2:1617
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354
Practice Address - Country:US
Practice Address - Phone:909-558-4756
Practice Address - Fax:909-558-0309
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12218 16015811 1A207R00000X
CAA135647207RC0000X, 207RA0001X
HI16613207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease