Provider Demographics
NPI:1205098696
Name:TRAN, MARK MINH (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:MINH
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2121 E COAST HWY STE 110
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2121 E COAST HWY STE 110
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-1912
Practice Address - Country:US
Practice Address - Phone:949-629-4263
Practice Address - Fax:949-629-4266
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA121821207N00000X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology