Provider Demographics
NPI:1962863993
Name:TRAN, NANCY (DO)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19636 DEARBORNE CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6648
Mailing Address - Country:US
Mailing Address - Phone:714-717-3861
Mailing Address - Fax:
Practice Address - Street 1:19636 DEARBORNE CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6648
Practice Address - Country:US
Practice Address - Phone:714-717-3861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-18
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16027207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine