Provider Demographics
NPI:1265006746
Name:TRAN, ANTHONY (DPT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23141 MOULTON PKWY STE 111
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1241
Mailing Address - Country:US
Mailing Address - Phone:949-340-6927
Mailing Address - Fax:949-215-7246
Practice Address - Street 1:23141 MOULTON PKWY STE 111
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1241
Practice Address - Country:US
Practice Address - Phone:194-934-0692
Practice Address - Fax:949-215-7246
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA35683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist