Provider Demographics
NPI:1982227005
Name:TRAN, TAM (NP)
Entity Type:Individual
Prefix:
First Name:TAM
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:STE 1902
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4409
Mailing Address - Country:US
Mailing Address - Phone:781-888-0544
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1902
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4409
Practice Address - Country:US
Practice Address - Phone:808-885-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-2876363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIAPRN-2876OtherHAWAII NP LICENSE NUMBER